High-dose platinum combination therapy in pretreated patients with disseminated melanoma

There are no accepted second-line therapeutic options in patients with disseminated melanoma. We evaluated toxicity and efficacy of a combination therapy with cisplatin and carboplatin.

Fifty consecutively treated melanoma patients who were progressive after at least one previous chemotherapy received cisplatin 100 mg/m(2) intravenously and carboplatin 200 mg/m(2) intravenously in a 2-day regimen once every 28 days.

As grade 3 and 4 toxicities, leucopenia (14%), thrombopenia (10%), anaemia (22%), nausea (8%), nephrotoxicity (4%), hypomagnesaemia (80%) and hepatotoxicity (2%) were observed. Among 42 patients evaluable for response, 2 (4.7%) had complete remission, 4 (9.5%) had partial remission and 21 (50%) had stable disease. The median progression-free time was 17 weeks (range 0-156) for all patients and 39 weeks (range 17-156) for patients with objective responses. The median overall survival time for all patients from the start of therapy was 32 weeks (range 2-156). Melanoma inhibitory activity levels of <12 ng/ml before therapy were identified to be associated with a favourable survival.

Our results indicate that a combination of cisplatin and carboplatin in patients with pretreated disseminated melanoma has an acceptable safety profile, induces objective responses and may prolong survival.