Taxol and vinorelbine: a new active combination for disseminated malignant melanoma

We evaluated the activity and toxicity of two sequences of taxol combined with vinorelbine in disseminated malignant melanoma, metastatic beyond regional lymph nodes. Fifteen previously untreated patients, nine males and six females (median age 56 years), were enlisted between May 1994 and February 1995. Eight patients received vinorelbine 30 mg/m2 (maximum dose 50 mg) first, follow 24 h later by taxol 120 mg/m2 (maximum dose 240 mg) infused over 3 h (the V/T sequence). Seven patients received the reverse (T/V) sequence. In 79 administered courses there were no anaphylactic episodes, the main toxicity being alopecia (WHO grade 3). Significant neutropenia, emesis or neuropathy was not observed in either schedule (WHO grades 0 or 1). Three major responses, all with the V/T sequences, were seen; one complete (CR) in nodal and cutaneous sites lasting 13 months and two partial (PR), omental, ascites in one and hepatic, splenic and nodal in the other, lasting 7 and 6 months, respectively. Clinically meaningful tumor regressions, not qualifying strictly for the criteria of major response, were observed in two additional patients in the T/V sequence. Taxol combined with vinorelbine is active against disseminated malignant melanoma. The importance of sequencing the two drugs remains to be determined with accrual of more patients into the study.