DACARBAZINE, CISPLATIN AND CARMUSTINE, WITH OR WITHOUT TAMOXIFEN, FORMETASTATIC MELANOMA - 5-YEAR FOLLOW-UP

Metastatic melanoma has a grim prognosis. Response rates and survival of patients treated with combination chemotherapy are not superior to single-agent chemotherapy. This study seeks to evaluate the objective response rate and survival of patients with metastatic melanoma treate d with multiagent chemotherapy, with or without tamoxifen, Forty-two p atients with metastatic melanoma were treated from March 1982 to Febru ary 1988 with dacarbazine, cisplatin and carmustine, with or without t amoxifen, An overall objective response rate of 43% was seen (complete response rate 17%; partial response rate, 26%), The response rate was 54% for patients treated with tamoxifen and 25% for patients treated without tamoxifen, but the results did not achieve statistical signifi cance, Median overall survival was 412 days, and was significantly lon ger in the tamoxifen-treated group. Combination chemotherapy as descri bed in this study is well-tolerated. The observation that tamoxifen ap pears to impact on survival should be interpreted with great caution d ue to the deficiencies in the design of the trial and small patient nu mbers, A randomized trial of this regimen vs single-agent chemotherapy is indicated and is currently being conducted.