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Related Experiment Videos

Systemic therapy in melanoma

F E Nathan1, M J Mastrangelo

  • 1Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. f_nathan@lac.jci.tju.edu

Seminars in Surgical Oncology
|May 20, 1998
PubMed
Summary

For advanced melanoma, the Dartmouth regimen (dacarbazine, carmustine, cisplatin, and tamoxifen) shows promise for remission. Combination therapies, including biotherapy, may improve outcomes for metastatic melanoma patients.

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Area of Science:

  • Oncology
  • Medical Pharmacology

Background:

  • Advanced melanoma poses significant challenges for medical oncologists.
  • Current single-agent chemotherapy offers limited remission rates for metastatic melanoma.

Purpose of the Study:

  • To evaluate the efficacy of novel combination chemotherapy regimens for surgically incurable melanoma.
  • To compare the effectiveness of the Dartmouth regimen against single-agent dacarbazine (DTIC).

Main Methods:

  • Review of existing data on single-agent chemotherapy (dacarbazine) and combination regimens.
  • Ongoing prospective randomized trials comparing DTIC alone versus the Dartmouth regimen (DTIC + carmustine + cisplatin + tamoxifen).
  • Evaluation of biological agents (interferon, interleukin-2) and combined chemo-biotherapy approaches.

Main Results:

  • The Dartmouth regimen appears more effective than DTIC alone, pending trial completion.
  • Biological agents show lower response rates but potentially longer response durations.
  • Combined chemo-biotherapy offers potential for higher response rates and durable remissions.

Conclusions:

  • While advanced melanoma is often not curable, current systemic therapies can induce significant remissions.
  • Combination regimens, including the Dartmouth regimen, and chemo-biotherapy show promise for improving patient outcomes.
  • High-dose regimens with stem cell support have not yet demonstrated sufficient benefit to outweigh toxicity.

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