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Systemic chemotherapy for malignant melanoma.

¹Sydney Melanoma Unit, University of Sydney, Sydney, New South Wales, Australia.

World Journal of Surgery

|March 1, 1992

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Malignant melanoma shows resistance to chemotherapy, with limited response rates for standard agents. Strategies like modulating glutathione may enhance alkylating agent efficacy for this challenging cancer.

Area of Science:

Oncology
Dermatology
Pharmacology

Background:

Malignant melanoma is highly resistant to conventional chemotherapy, with response rates around 20% for standard single agents.
Adjuvant therapies have not proven effective for post-surgical treatment of primary or regional lymph node disease.
Combinations of chemotherapy drugs have not demonstrated superiority over single agents in treating melanoma.

Purpose of the Study:

To review the current landscape of chemotherapy for malignant melanoma.
To explore novel strategies for overcoming chemoresistance in melanoma.
To provide guidance on treatment approaches for metastatic melanoma.

Main Methods:

Literature review of studies on chemotherapy agents and treatment strategies for malignant melanoma.

Related Experiment Videos

Analysis of response rates and long-term outcomes for various therapeutic interventions.

Discussion of emerging strategies, including biological response modifiers and drug resistance mechanisms.

Main Results:

Standard single agents like dacarbazine and nitrosoureas yield response rates of approximately 20%, with occasional long-term remissions.
Newer agents such as cisplatin and fotemustine show activity.
High-dose alkylating agents and isolated limb perfusion suggest resistance is not absolute, pointing to glutathione modulation as a potential strategy.

Conclusions:

While chemotherapy resistance is a major challenge in malignant melanoma, strategies like glutathione modulation offer potential for improved efficacy.
Observation without treatment is a valid approach for asymptomatic metastatic melanoma patients.
Single-agent dacarbazine or lomustine are reasonable choices for chemotherapy outside of clinical trials.