CHEMOHORMONE THERAPY OF METASTATIC MELANOMA WITH MEGESTROL-ACETATE PLUS DACARBAZINE, CARMUSTINE, AND CISPLATIN

Background. Chemotherapy with dacarbazine, carmustine, and cisplatin p roduces a modest objective response rate in melanoma. Megestrol acetat e may ameliorate cachexia, abrogate drug resistance, and increase surv ival time in melanoma. Methods. Nineteen patients with metastatic mela noma (16 evaluable) treated with dacarbazine (220 mg/ m(2)/day for 3 d ays, intravenously [IV]), cisplatin (25 mg/ m(2)/day for 3 days IV) ev ery 3 weeks, and carmustine (150 mg/m(2) IV single dose every 6 weeks) together with megestrol acetate (160 mg/day by mouth continuously) st arting 2 days before chemotherapy. Results. This regimen was well tole rated and resulted in a mean net weight gain of 1.45 kg. A 47% objecti ve response rate was observed in all patients, including visceral site s of response, with a 39+ week median duration of response and median survival time of 16.7+ months in all evaluable patients. Conclusions. In this small Phase II study, the authors showed that megestrol acetat e may contribute to a high objective response rate and prolonged media n survival when used with a chemotherapy regimen of dacarbazine, carmu stine, and cisplatin.