Cisplatin and carboplatin combination as second-line chemotherapy in dacarbazine-resistant melanoma patients

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.