Biochemotherapy in the treatment of metastatic melanoma in selected patients

Clin Transl Oncol. 2009 Jun;11(6):382-6. doi: 10.1007/s12094-009-0372-4.

Abstract

Introduction: Bioimmunochemotherapy (BCT) is a combination of biological agents and cytostatics that has shown an increase in response rate (RR) in metastatic melanoma patients. The aim of the study is to evaluate RR, progression- free survival (PFS), overall survival (OS) and treatment toxicity.

Materials and methods: Retrospective analysis of 11 metastatic melanoma patients treated from January 2002 to June 2008 with cisplatin 20 mg/m(2) i.v. days 1.4, dacarbazine 800 mg/m(2) i.v. day 1, vinblastine 1.5 mg/m(2) i.v. days 1.4, interleukin (IL)-2 9 MIU/m(2) s.c. 5.8 days and interferon (IFN)-alpha-2b 5 MIU/m2 s.c. days 5.9, 11, 13 and 15, with the support of granulocyte colony-stimulating factor (G-CSF) and antibiotics. Patients with ECOG 0, age < or = 65 years and with measurable disease were included. The planned number of courses was 4. RR was measured by Revised Evaluation Criteria in Solid Tumour (RECIST) criteria (computed tomography [CT]+/-proton emission tomography [PET]). Toxicity was measured according to the National Cancer Institute (NCI) common toxicity criteria.

Results: Observed RRs were 18% complete response (CR), 27% partial response (PR), 9% stable disease (SD) and 46% disease progression. The median PFS was 4 months (95% CI, 0.10 m), with a 23% one-year PFS. Median OS was 4.6 months (95% CI, 0.9.19 m), with a 29% one-year OS. Eighty-three percent of patients experienced grade 3-4 toxicity, mainly due to neutropenia, thrombocytopenia and flu-like syndrome.

Conclusions: Treatment with BCT shows an increase in RR, some achieving durable CR; nevertheless it cannot be considered a standard treatment and should be employed only in selected patients.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Clinical Trials, Phase III as Topic
  • Dacarbazine / administration & dosage
  • Dacarbazine / adverse effects
  • Disease-Free Survival
  • Drug Evaluation
  • Female
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use*
  • Immunotherapy*
  • Interferon alpha-2
  • Interferon-alpha / adverse effects
  • Interferon-alpha / therapeutic use*
  • Kaplan-Meier Estimate
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / mortality
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / therapy
  • Male
  • Melanoma / drug therapy
  • Melanoma / mortality
  • Melanoma / secondary*
  • Melanoma / therapy
  • Meta-Analysis as Topic
  • Middle Aged
  • Multicenter Studies as Topic
  • Patient Selection
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Recombinant Proteins
  • Remission Induction
  • Retrospective Studies
  • Soft Tissue Neoplasms / drug therapy
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / secondary*
  • Soft Tissue Neoplasms / therapy
  • Vinblastine / administration & dosage
  • Vinblastine / adverse effects

Substances

  • Immunologic Factors
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Vinblastine
  • Dacarbazine
  • Cisplatin