[Contribution of a new nitrosourea compound: fotemustine]

Fotemustine is a new nitrosourea which is active against disseminated malignant melanoma. A global response rate (RR) of 24.2% was obtained in a multicenter trial including 153 patients. The RR was 25% on cerebral metastases. A multivariate analysis of the long term survival considering the main prognostic factors, has been achieved. It confirms the efficacy of fotemustine. As a matter of fact, the best survival of good responders compared to non responders is not correlated to the metastatic site. The combination of fotemustine and dacarbazine led to a global RR of 27.2%, up to 40% in non visceral metastases. As an other way of research the administration of fotemustine by the intraarterial hepatic route in the treatment of hepatic metastases of malignant ocular melanoma seems to give higher response rates than those obtained with chemotherapies administered by intravenous route (near 40% of response rate). Fotemustind alone or associated with cisplatinum allowed also interesting results in the treatment of metastatic non small cell lung cancer (NSCLS).