Concurrent chemobiotherapy with cisplatin, dacarbazine, decrescendo interleukin-2 and interferon alpha2b in patients with metastatic melanoma

We aimed to evaluate a concurrent chemobiotherapy (CBT) regimen consisting of cisplatin (CDDP), dacarbazine (DTIC), decrescendo interleukin-2 (IL-2), and interferon alpha2b (INF-alpha2b), in metastatic melanoma patients. A total of 60 patients with biopsy proven, metastatic melanoma were treated between October 2000 and November 2005 at the Oncology Institutes of RMC and CSMC. Patients received concurrent CBT for 5 days, consisting of CDDP, DTIC, decrescendo IL-2, and subcutaneous INF-alpha2b. GM-CSF was given subcutaneously on days 8 to 12 of each cycle, to the first 26 patients. Treatment was administered q21d for a total of six cycles or until severe toxicity or progression; 57 patients who received at least two cycles, followed for at least 24 months, were included in response analysis. The overall response rate (RR) reached 44% (28/57 patients); 14 patients had a complete response (CR, 25%); 11 (19%) reached a partial response. The median progression-free survival was 7 months. Median overall survival (OS) was 11.7 months. At a median follow-up of 29 months, 8 of 14 complete responders remain alive for more than two years, with no clinical evidence of disease. Median OS of patients with CR has not been reached; 17% of the courses were modified due to toxicity, and 20% of the patients were removed from the protocol due to toxicity or refusal to continue. The data from this study indicate that this protocol of concomitant CBT is feasible with a fraction of the patients achieving a durable CR.