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Actinomycin‐D, levamisole chemoimmunotherapy of refractory malignant melanoma
Author(s) -
Hall Stephen W.,
Benjamin Robert S.,
Lewinski Uri,
Mavligit Giora
Publication year - 1979
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197904)43:4<1195::aid-cncr2820430406>3.0.co;2-m
Subject(s) - chemoimmunotherapy , levamisole , medicine , melanoma , refractory (planetary science) , oncology , cancer research , dermatology , immunotherapy , cancer , biology , astrobiology
Sixty adult patients with disseminated melanoma refractory to DTIC or Dacarbazine were given chemoimmunotherapy with intermittent high single dose Actinomycin‐D and Levamisole. Actinomycin‐D was given at a dose of 1.5‐2.0 mg/m 2 intravenously every 3 to 4 weeks. Levamisole was given in a dose of 150 mg/day for two consecutive days each week (50 patients) and in a dose of 200 mg every other day (10 patients). Antitumor responses consisted of 2% complete remissions (CR), 2% partial remissions (PR), and 33% disease improvement less than PR or stabilization (S). Comparison of these patients who received Actinomycin‐D + Levamisole with those on an immediately preceding study in a similar population where Actinomycin‐D was given as a single agent revealed no difference in response rates. Patients who responded to Actinomycin‐D + Levamisole (CR + PR + S) survived significantly longer (35 weeks) than nonresponders (12 weeks, p < 0.01). Survival was not longer (p <.05) in responding patients (CR + PR + S) receiving Actinomycin‐D + Levamisole (35 weeks) compared to those responding to Actinomycin‐D alone (18 weeks, p = 0.09). Hematologic toxicity was tolerable with median lowest granulocyte counts of 1.6 × 10 3 /μ1 and platelet counts of 134,000/μ1. Other toxic effects were predominantly nausea, vomiting, and mucositis. In those patients who received alternate day Levamisole there was greater gastrointestinal upset as well as fever, rash and central nervous system toxicity which was unacceptable.