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Biochemotherapy for the treatment of metastatic melanoma: the experience of a tertiary oncology center
Author(s) -
JOHN Thomas,
CEBON Jonathan S,
DAVIS Ian D
Publication year - 2005
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2005.00016.x
Subject(s) - medicine , regimen , chemotherapy , oncology , melanoma , toxicity , progressive disease , clinical trial , surgery , cancer research
Background: Malignant melanoma is generally resistant to cytotoxic chemotherapy. The addition of cytokines such as interleukin‐2 (IL‐2) and Interferon‐α (IFNα) to cytotoxic chemotherapy has been reported to result in significant improvement in response rates and time to treatment progression. There have also been reports of long‐term survival in a subset of patients who achieved a complete remission. While this treatment has promised significant improvement in tumor response, to date this has not translated into an increase in median overall survival in adequately powered randomized phase III studies. The Joint Ludwig Austin Oncology unit operates a clinic for patients with advanced malignant melanoma. On the basis of early encouraging reports, we have treated selected patients, over a 5‐year period, using a combination biochemotherapy regimen. Here, we report our experience with the treatment regimen. Methods: Records from patients treated with biochemotherapy were examined for baseline characteristics, prior treatments and sites of disease. Outcomes measured included response, toxicity, hospitalization and survival. Results: Between 1999 and 2003, 14 patients were treated at the Austin Hospital. There were four partial responses (PR) and two disease stabilizations lasting 7 months (SD). The overall clinical benefit (PR + SD) was 42.8% (6/14). The regimen was toxic with significant hematological and constitutional toxicity, although no treatment related deaths occurred. Patient survival with Stage 4 disease ranged from 2 to 60 months. Conclusions: These results are consistent with published data from other institutions. Because this is palliative treatment, results in significant toxicity and has failed to result in a survival benefit when tested in randomized studies we do not feel that off‐study treatment with this regimen is justified. Further studies are needed into mechanisms of resistance and response prediction to determine whether any subgroups of patients with metastatic melanoma might benefit from this treatment.