Sequential chemoimmunotherapy for metastatic melanoma

Since February, 1990 we have evaluated a sequential form of chemoimmunotherapy as an investigative method for the treatment of metastatic melanoma. A cycle of therapy consisted of: carmustine (150 mg/m2) on day 1, dacarbazine (220 mg/m2) and cisplatin (25 mg/m2) on days 1 through 3 and 22 through 24, interleukin-2 (1.5 x 10(6) IU/m2 every 8 hours) and alpha-interferon (IFN alpha) (6.0 x 10(6) IU/m2 subcutaneously once daily) on days 4 through 8 and 17 through 21, and tamoxifen 10 mg orally twice daily for 6 weeks. Patients were evaluated for response 2 to 3 weeks after completing each cycle of therapy. Thirty-nine patients had been entered into this trial as of December 1, 1990, and 25 had completed at least one cycle of therapy and have been evaluated for response. The responses are as follows: complete response, six of 25 (24%); partial response, nine of 25 (36%); minor response, one of 25 (4%); stable disease, eight of 25 (32%); and progressive disease, one of 25 (4%). Median response duration has not been reached but is at least 5 months. Immunologic alterations associated with response and associated toxicity data will be presented.