SALPETRIERE HOSPITAL EXPERIENCE WITH BIOCHEMOTHERAPY IN METASTATIC MELANOMA

PURPOSE This article investigates the safety and efficacy-of a simple cisplatin-based biochemotherapy regimen, containing single-agent cispl atin plus recombinant interleukin-2 (rIL-2) and recombinant interferon -alpha, (IFN-alpha), in the treatment of metastatic melanoma. PATIENTS AND METHODS Between December 1990 and April 1997, 129 patients were t reated with cisplatin (100 mg/m(2), day 0) plus continuous intravenous infusion rIL-2 (18 MIU/m(2)/day, days 3-6 and days 17-21) and subcuta neous rIFN-alpha (9 MIU three times per week) plus or minus tamoxifen (160 mg/day) on three different protocols. Tumor response, disease-fre e survival, and overall survival were evaluated for all evaluable pati ents (N = 127). RESULTS The overall response rate was 43%, and 10% of patients achieved a complete response, Responses were observed at all sires of metastases. In one case, a patient with a large cutaneous ing uinal mass experienced a dramatic regression of that lesion within 1 m onth. The median disease-free survival was 5 months, and median overal l survival was 11 months. Patients who responded had a significant sur vival advantage over nonresponders, and patients who achieved a comple te response had a significant survival advantage over patients with a partial response. Toxicities were manageable and reversible upon disco ntinuation of therapy. CONCLUSION Tile response rates achieved with th is simple biochemotherapy regimen are comparable to those for other ci splatin-based biochemotherapy regimens, which use more complex multiag ent chemotherapy regimens. We found no added clinical benefit from the addition of tamoxifen to cisplatin.