Adjuvant Chemotherapy With Dacarbazine, Vindesine, and Cisplatin in Pathological Stage II Malignant Melanoma

Pectasides, Dimitrios; Alevizakos, N; Bafaloukos, D.; A, Tzonou; Asimakopoulos, George; Varthalitis, I-I; Dimitriadis, M.; Athanassiou, A.

doi:10.1097/00000421-199402000-00012

Cited by 19 publications

(4 citation statements)

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“…The regimen should be investigated in respect to a lower toxicity, less costs, and what part of this high-dose therapy is really needed to achieve the therapeutic benefit. Trials are underway to answer some of these questions ( [46] vant IFN studies suggests that patients have a benefit from HDI as well as from LDI therapy [32].…”

Section: Discussion and Treatment Recommendationsmentioning

confidence: 99%

Adjuvant Therapy in Melanoma

Mohr

Weichenthal²,

Hauschild³

2003

Oncol Res Treat

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Despite intensive research and numerous clinical trials on the adjuvant treatment of patients with high-risk cutaneous melanoma, the issue is still controversial. Early positive results from studies on adjuvant chemo- and immunotherapy were based on historical controls and could not be confirmed by prospective randomized trials. The effect of interleukin-2 in the adjuvant treatment of malignant melanoma is not yet clearly defined. Combined treatment modalities like bio-chemotherapy are still to be analyzed in controlled clinical trials, and results of new studies with active specific immunization (vaccination) will only be available within the next years. Only interferon alpha (IFN α) has shown reproducible superiority over observation for high-risk melanoma patients in large prospective randomized trials with respect to disease-free survival (DFS) and partially for overall survival (OS). These studies resulted in the approval of IFN α for the adjuvant treatment of malignant melanoma in many countries. Low-dose IFN has shown significant prolongation of DFS, but so far failed to improve OS. The question whether high-dose IFN has shown enough superiority over observation with respect to OS based on one negative and two positive trials to make it the standard therapy in stage IIb,c and stage III melanoma patients still remains unanswered. Results from intermediate-dose IFN α, pegylated IFN α, and modified high-dose interferon schedules are pending. In conclusion, interferon is the cornerstone of adjuvant therapy in high-risk melanoma today, but the optimal dosage and duration of treatment are still to be defined. Patients with high-risk malignant melanoma should preferentially be treated in prospective randomized multicenter trials to give more detailed data for treatment recommendations.

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Section: Discussion and Treatment Recommendationsmentioning

confidence: 99%

Adjuvant Therapy in Melanoma

Mohr

Weichenthal²,

Hauschild³

2003

Oncol Res Treat

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“…A trial conducted by Pectasides et al in Greece [36] with a combination of dacarbazine, vindesine and cisplatin in an adjuvant setting showed no difference in survival or disease free survival (Table 2).…”

Section: Combination Chemotherapymentioning

confidence: 99%

Adjuvant treatment for high risk melanoma. Where are we now?

2008

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The survival rate for stage 3 and 4 melanoma is very poor. In the absence of effective treatments for metastatic disease focus has shifted to the adjuvant setting. While we are now able to identify those who are at high risk of recurrence the role of adjuvant systemic treatment in these individuals is still undefined. This is partly due to the lack of effective treatments, despite the advances in the understanding of the biology of melanoma and the natural history of the disease process. Of the various treatments studied in the adjuvant setting only interferons and vaccines have been shown to affect the clinical outcome but no agent has been accepted as a standard, with differences in practice between the US and Europe. In this review article we will report what is known at this time about the different agents studied in the adjuvant setting and refer to some new areas of research that may play a bigger role in the future management of melanoma.

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“…In contrast to other studies, the authors demonstrated a modest benefit in both DFS and OS in favour of the treated group. Not unexpectedly, combination chemotherapy has faired no better than other approaches (Pectasides et al, 1994).…”

Section: mentioning

confidence: 99%

The effect of tamoxifen and cisplatin on the disease-free and overall survival of patients with high risk malignant melanoma

McClay

Monroe

et al. 2000

Br J Cancer

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The adjuvant treatment of high-risk malignant melanoma remains problematic. Previously we reported moderate success in the treatment of metastatic disease using tamoxifen, cisplatin, dacarbazine and carmustine. Based upon data that suggested tamoxifen and cisplatin were the active agents in this regimen, we initiated a phase II trial of this combination in the adjuvant setting. We treated 153 patients with 4 cycles of tamoxifen (160 mg day–1, days 1–7) and cisplatin (100 mg m–2, day 2) for 28-day intervals. Patients received an anti-nausea regimen of dexamethasone with ondansetron or granisetron. During the first 2 years of follow-up, patients were evaluated every 2 months with a history, physical exam, laboratory work and computed tomography scans of the chest, abdomen and pelvis every 4 months. Thereafter, patients were evaluated every 3 months and radiographic studies were performed if necessary. Currently, with a median follow-up of 36 months, the disease-free survival (DFS) is 68.4% and overall survival (OS) is 84.5%. Kaplan–Meier analysis predicts a 5-year DFS of 62% with an OS of 79%. Relapses after 20 months have been rare. No effect of gender or number of positive lymph nodes was noted, however, stage of disease prior treatment was a factor. The major toxicity proved to be gastrointestinal in nature with nausea the most prevalent symptom. Minimal renal, haematologic and neurologic toxicity occurred. These preliminary results suggest that there is a positive impact of tamoxifen and cisplatin on both the DFS and OS of high-risk malignant melanoma patients. The 5-year projected DFS and OS compare favourably with those reported for the ECOG 1684 trial and warrant confirmation in a prospective randomized trial. © 2000 Cancer Research Campaign

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Adjuvant Chemotherapy With Dacarbazine, Vindesine, and Cisplatin in Pathological Stage II Malignant Melanoma

Cited by 19 publications

References 0 publications

Adjuvant Therapy in Melanoma

Adjuvant Therapy in Melanoma

Adjuvant treatment for high risk melanoma. Where are we now?

The effect of tamoxifen and cisplatin on the disease-free and overall survival of patients with high risk malignant melanoma

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