LONG-TERM RESPONSE TO CHEMOTHERAPY IN PATIENTS WITH VISCERAL METASTATIC MELANOMA

Patients and methods: Eight patients who remain in long term remission 4 to 15 years after chemotherapy for visceral metastatic melanoma are described. These patients were observed among some 1100 patients with visceral melanoma seen at the Sydney Melanoma Unit between 1977 and 1 989. Only about one-third of such patients received chemotherapy, almo st always with single agent dacarbazine or a nitrosourea. Results: The apparently cured patients did not differ from the overall group of pa tients with visceral metastases in baseline characteristics, but 6 of the 8 bad nodular lung metastases. Conclusions: While the mechanism re mains uncertain, one possibility could be that chemotherapeutic agents cause mutations which allow expression of antigenicity in tumour cell s. In any case, the fact of occasional exceptionally good responses, p erhaps amounting to cure, constitutes an argument for a trial of chemo therapy in patients with visceral metastatic melanoma.