Biochemotherapy with carmustine, cisplatin, dacarbazine, tamoxifen and low-dose interleukin-2 for patients with metastatic malignant melanoma.

Abstract

BACKGROUND:

The toxicity and efficacy of biochemotherapy with low-dose interleukin-2 for patients with metastatic malignant melanoma (MM) were studied.

METHOD:

Metastatic chemo-naive MM patients were given biochemotherapy (BCDT regimen) with carmustine (BCNU), cisplatin (CDDP), dacarbazine (DTIC), and tamoxifen and interleukin-2 (IL-2) 18 Million International Units in divided doses by subcutaneous injection three times a week for four weeks. BCDT consisted of BCNU (150 mg/m2, day l every 8 weeks), CDDP (25 mg/m2, days l-3 every 4 weeks), DTIC (220 mg/m2, days 1-3 every 4 weeks) and tamoxifen 10 mg twice a day. Treatment was repeated for a total of 6 cycles, or until disease progression or unbearable toxicity.

RESULTS:

From Nov 2001 to July 2005, 40 patients (20 men; 20 women) were enrolled. Their median age was 54 years (range 22-79 years). Subtypes of melanoma included 23 (57.5%) acral lentiginous, 11 (27.5%) nodular, 1 (2.5%) mucosal, and 5 (12.5%) others. Grade 3-4 toxicities included neutropenia (27.5%), anemia (45%), and thrombocytopenia (40%). Constitutional IL-2 toxicities included indurate injection site (57.5%), fever (60%), chills (55%), itchy skin (42.5%), bone pain (32.5%) and myalgia (45%). Grade 1-2 hypotension was noted in 12.5% of patients. Eosinophilia (range 5% to 71%) was evident in 72.5% of patients. The response rate was 32.5% including 5% with a complete response, 27.5% with a partial response, and 17.5% with stable disease. The median progression-free survival was 6.2 months (95% CI: 2.9~9.6 months). The median overall survival was 11.3 months (95% CI: 7.0~15.6 months). Five patients (12.5%) who presented with oligo-metastasis achieved five-year survivals.

CONCLUSIONS:

Our data demonstrated that low-dose IL-2 plus BCDT is tolerable. A durable response and long-term survival can be achieved in a small subgroup of patients.

• Authors: Po-Jung Su, Jen-Shi Chen, Chuang-Chi Liaw, Hsien-Kun Chang, Hung-Ming Wang, Tsia-Sheng Yang, Yung-Chang Lin, Chi-Ting Liau, Hsin-Yi Yang, Kun-Yun Yeh, Ming-Mo Ho, Nai-Jun Chang, Cheng-Hsu Wang, John Wen-Chen Chang
• Journal: Chang Gung medical journal (Chang Gung Med J) 2011 Sep-Oct Vol. 34 Issue 5 Pg. 478-86 ISSN: 2309-835X [Electronic] China (Republic : 1949- )
• PMID: 22035892 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Interleukin-2
• Tamoxifen
• Dacarbazine
• Cisplatin
• Carmustine

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carmustine (administration & dosage)
• Cisplatin (administration & dosage)
• Dacarbazine (administration & dosage)
• Female
• Humans
• Interleukin-2 (administration & dosage)
• Male
• Melanoma (drug therapy, mortality, pathology)
• Middle Aged
• Neoplasm Metastasis
• Tamoxifen (administration & dosage)