K. Guven et al., Cisplatin and carboplatin combination as second-line chemotherapy in dacarbazine-resistant melanoma patients, MELANOMA RE, 11(4), 2001, pp. 411-415
High-dose cisplatin regimens have been shown to be highly active in advance
d melanoma patients but are associated with unacceptable side effects. In o
rder to increase the platinum dose but avoid severe side effects, we treate
d 15 dacarbazine (DTIC)-resistant metastatic melanoma patients with a combi
nation regimen of cisplatin (100 mg/m(2)) and carboplatin (200 mg/m(2)), tw
o platinum analogues with a similar mode of action but a different toxicity
pattern. After a mean follow-up period of 10.7 months (range 4-18 months),
two patients (13.3%) achieved complete remission and two patients (13.3%)
showed partial remission, giving an overall response rate of 26.4% (95% con
fidence interval [CI] 4.2-49%). Furthermore, three patients (20%; 95% CI 0-
40.2%) experienced stable disease. The median duration of response was 7.1
months (95% Cl 4.2-10.0 months), and the median overall survival was 12.5 m
onths (95% CI 5.8-19.2 months), with eight patients still alive. The main s
ide effects were haematological (leukopenia/thrombocytopenia World Health O
rganization [WHO] grade I-IV; anaemia WHO grade I-III), gastrointestinal (W
HO grade I-III), neurological (WHO grade I-II) and renal (WHO grade I) toxi
city. Nevertheless, except in one patient, side effects did not result in d
iscontinuation of therapy. Despite the small number of patients treated in
this preliminary study, we believe that combining cisplatin and carboplatin
represents a novel, active and well-tolerated therapeutic option as second
-line chemotherapy in DTIC-resistant advanced melanoma patients. (C) 2001 L
ippincott Williams & Wilkins.