Adjuvant chemotherapy in the management of primary malignant melanoma

Abstract

In a prospective randomized study, the effect of chemotherapy (either systemic or combined intraarterial and systemic) was studied in 117 patients undergoing a curative resection of Clark's level 111, IV or V malignant melanoma. Systemic chemotherapy was started one montb after surgery one week courses with a n I.V. injection of Vinblastin 6 mg/m2, Thiotepa 6 mg/m2, Rufocromomycine 60 pg/m2, Methotrexate 15 mg/m2 on day one with procarbazine 30 mg/m2 orally daily were given every other week for three months and later every four weeks. Intraarterial chemotherapy of DTIC 80 mg/kg/day for ten days was given 28 days prior to surgery. 65 patients with limb malignant melanoma were treated either by surgery only (27 patients), or by systemic chemotherapy (23 patients) o r by preoperative intraarterial chemotherapy and systemic chemotherapy (15 patients): 52 patients with non limb malignant melanoma were treated either by surgery only (28 patients) or by systemic chemotherapy (24 piitients). We drew curves of disease free survival following surgery and studied the levelling off of the curves, 24 months after surgery 65% of the patients treated by surgery alone were alive and free of disease whereas 81% of the patients treated by surgery and chemotherapy were alive and free of disease ( p < 0.05) suggesting a possible benefit of adjuvant chemotherapy. Intraarterial preoperative chemotherapy has not proved of additional benefit to date.Cancer 41:1240-1248, 1978. H E MAJORITY OF PATIENTS WITH MALIGNANTT melanoma die within 10 years from dissemination of disease. Significant improvement in overall survival may be expected from treatment which can control subclinical metastasis present at the time of primary treatment.

Understanding cancer and the anticancer activities of naphthoquinones – a review

“…[137][138][139][140][141][142] Positive results were, however, reported for SN in the treatment of leukemias, lymphomas and melanomas. [143][144][145][146][147] DTdiaphorase, an enzyme showing increased activity in certain tumours such as human non-small cell lung cancer, efficiently bio-activates SN. 148,149 It was therefore proposed SN could be used against tumours with increased DT-diaphorase function.…”

Novel Cyano- andN-Isopropylamidino-Substituted Derivatives of Benzo[b]thiophene-2-carboxanilides and Benzo[b]thieno[2,3-c]quinolones: Synthesis, Photochemical Synthesis, Crystal Structure Determination, and Antitumor Evaluation. 2

“…Novel quinoline−quinone, e.g. streptonigrin (SN), is an antitumor antibiotic that has activity against a broad range of tumors. − SN was studied clinically as an antitumor agent, but its use was limited by reports of delayed myelotoxicity. , Nevertheless, positive results were reported for SN both as a single agent , and in combination chemotherapy. , SN is an excellent substrate for oxidoreductase (NQ01) …”

Novel Derivatives of Benzo[b]thieno[2,3-c]quinolones: Synthesis, Photochemical Synthesis, and Antitumor Evaluation

“…Few data have been publish describing the antitumor activity of heterocyclic condensed quinolones. The novel quinoline-quinone streptonigrin (SN) is an antitumor antibiotic that has activity against a broad range of tumors. − Although SN has been studied clinically as an antitumor agent, its use has been limited by reports of delayed myelotoxicity. , Nevertheless, positive results were reported for SN either as a single agent , or in combination chemotherapy. , SN is an excellent substrate for oxidoreductase (NQ01) …”

“…15,16 Nevertheless, positive results were reported for SN either as a single agent 17,18 or in combination chemotherapy. 19,20 SN is an excellent substrate for oxidoreductase (NQ01). 21 Pyranoquinolin-2-ones were synthesized and evaluated for their in vitro cytotoxicity against a panel of human tumor cell lines, 22 and 2-arylquinazolinones had significant growth inhibitory action against tumor cell lines, some of them being potent inhibitors of tubulin polymerization.…”