Megestrol melanoma study

Area of Science:

• Oncology
• Pharmacology

Background:

• Metastatic melanoma with visceral involvement presents a significant treatment challenge.
• Standard chemotherapy regimens have shown limited efficacy in improving long-term survival for such patients.

Purpose of the Study:

• To evaluate the efficacy and safety of adding megestrol acetate to a dacarbazine, cisplatin, and carmustine chemotherapy regimen for metastatic melanoma.
• To assess the impact on objective response rate, duration of response, and overall survival.

Main Methods:

• A cohort of 22 patients with metastatic melanoma received chemotherapy (dacarbazine, cisplatin, carmustine) combined with megestrol acetate.
• Dosing details included megestrol acetate (160 mg/day PO), dacarbazine (220 mg/m2/day IV for 3 days), cisplatin (25-30 mg/m2/day IV for 3 days) every 3 weeks, and carmustine (150 mg/m2 IV single dose) every 6 weeks.
• Toxicity, dosing adherence, weight changes, objective response rate, duration of response, and survival were monitored.

Main Results:

• An objective response rate of 56% was observed, including responses in visceral sites.
• The median duration of response was 37.5+ weeks.
• A median survival of 15 months was achieved, exceeding that of most prior studies.
• Toxicity was tolerable, with over 80% of ideal dosing achieved in the first two cycles.
• A mean weight gain of 0.95 kg was noted.

Conclusions:

• Megestrol acetate, when combined with dacarbazine, carmustine, and cisplatin chemotherapy, may enhance objective response rates and prolong median survival in patients with viscerally dominant metastatic melanoma.
• The combination therapy demonstrated tolerable toxicity and potential for weight gain.