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Year:
2004
| Volume: 12
| Issue: 1
| Pages: 25-28
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Original Article |
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THE EFFECT OF COMBINED CHEMOTHERAPY WITH OR WITHOUT POTENTIATION WITH INTERFERON ALPHA OR TAMOXIFEN FOR MELANOMA
Ivica PEJCIC, Svetislav VRBICA, Sladjana FILIPOVIC, Ljiljana PEJCICA, Braslav JOVANOVIC, Mirjana SCEKIC, Aleksandra FILIPOVIC |
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DOI:
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Abstract: |
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Background: Metastatic melanoma has shown only limited responsiveness to chemotherapy or immunotherapy. The most commonly used single-agent chemotherapy comes from the nitrosourea group of agents and provides response rates of less than 20%. Several cytotoxic agents have been combined with no dramatic benefit. The incorporation of tamoxifen or interferon in chemotherapy regimens has proven effective in some trials.
Methods: From July 1998 to March 2002, 45 patients with metastatic melanoma were enrolled for the study. None of the patients had previously received chemotherapy. The aim of the study was to compare the activity of three combined regimens: CVD (cisplatin, vinblastine, dacarbazine) chemotherapeutic combination, CVD with interferon (IFN) alpha-2 - biochemotherapy, and CVD with tamoxifen. The study was conducted as a single center, controlled, prospective, randomized phase II study directed toward the disease.
Results: The best response rate (RR) was observed in the CVD+IFN (6/15) group related to the CVD (4/15) and CVD+TAM (3/15) groups, without significant difference though. In 29 patients with 1 to 2 metastatic lesions, RR was 44.82% (CR-1, PR-12, SD-13, PD-3), while in 16 patients with 3 or more metastatic lesions RR was 0.0 % (CR-0, PR-0, SD-9, PD-7). The difference was statistically significant (p<0.005). The best responding metastatic sites were the lymph nodes (in 10 patients), but patients with lung, skin and liver lesions also responded. All patients experienced mild adverse effects. No treatment-related deaths occurred. The median survival was 12, 12, and 11 months in CVD+IFN, CVD and CVD+TAM group, respectively. Time to progression was about 8 months in all treated groups.
Conclusion: Combined chemotherapy, biochemotherapy or chemohormonal therapy all showed some activity in metastatic melanoma. However, it is not yet possible to define standard therapy for this disease. Due to a limited number of patients evaluated so far in this investigation the results should be clearer and more conclusive with larger cumulative number of cases enrolled. |
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Key words:
Melanoma; Neoplasm Metastasis; Treatment Outcome; Tamoxifen; Inteferon Alfa-2A |
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