What forms of chemotherapy are used in the treatment of metastatic melanoma?

Chemotherapy in metastatic melanomas yielded disappointing results with 5-year survival rates for treated patients ranging from 3% to 14%. There are currently no curative forms of therapy for patients with metastatic disease. Dacarbazine has shown some efficacy as single-agent therapy. Response rates average around 10% to 20%, with durations averaging 6 months, and a complete response rate of about 5%. Newer agents such as temozolomide (TMZ) are similar to dacarbazine but offer the advantages of oral administration, as well as penetration through the blood–brain barrier. Nevertheless, response rates average ~15%. Temozolomide has also been tried in combination with IFN-α and thalidomide; however, no increase in survival rates has been observed. Cisplatin has been shown to be somewhat effective as single-agent therapy, but it has significant toxicities. Other studies have shown that the nitrosoureas (carmustine, lomustine, and semustine) have an overall response rate ranging from 13% to 18%. Similarly, tubular toxins such as vinblastine, vincristine, and Taxol (paclitaxel) have led to response rates of between 12% and 15%. The combination of carboplatin and paclitaxel is currently under investigation.

Wolchok JD, Saenger YM: Current topics in melanoma, Curr Opin Oncol 19:116–120, 2007.