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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
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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.

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.

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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.