COMBINATION CHEMOTHERAPY OF FOTEMUSTINE-D ACARBAZINE AND INTERFERON-ALPHA FOR DISSEMINATED MALIGNANT-MELANOMA TREATMENT

In the treatment of disseminated malignant melanoma (DMM), the results obtained with fotemustine associated or not with dacarbazine are prom ising and those obtained with interferon alpha are also interesting. T herefore, we have investigated the efficacy and the toxicity of a comb ined chemotherapy with fotemustine-dacarbazine and interferon alpha in DMM. We present in this work our results on 44 patients who entered i nto this opened study. 37 patients were evaluable. 29 (78.4 p. 100) ha d previously received one or more cytotoxic chemotherapy. The regimen consisted of an induction treatment with fotemustine (100 mg/m2) on da ys 1.8, and 60 dacarbazine (400 mg/m2) on days 1, and 60 and subcutane ous injections of interferon (9.10(6) UI) alpha three times weekly. Re sponding and stabilized patients were given maintenance treatment with a monthly infusion of fotemustine (100 mg/m2) and dacarbazine (400 mg /m2) and interferon alpha carried on at the same dose. The response ra te was 10,8 p. 100 (3 PR + 1 CR). Responses have depended on metastati c sites (cerebral site 18,2 p. 100). The median duration of response w as 28 weeks. Toxicity was mainly hematologic and was acceptable. These results are not as good as those reported before with fotemustine and dacarbazine. Even if reasons related to patients and protocol could b e discussed, the association of interferon alpha, fotemustine and daca rbazine seems devoid of interest during induction treatment.