COMBINATION CHEMOTHERAPY FOR DISSEMINATED MALIGNANT-MELANOMA

Malignant melanoma, once disseminated, is associated with very short survival times and has proven highly resistant to systemic therapy. Although many chemotherapeutic agents can produce small response rates in these patients, the most consistent responses occur with dacarbazine (DTIC). Numerous combination regimens, with and without DTIC, have been tested against disseminated melanoma, with varying and inconsistent outcomes. The most encouraging results have occurred with the combination of DTIC, cisplatin, BCNU and tamoxifen. The use of high-dose chemotherapy with and without autologous bone marrow support and the addition of biologic agents such as inteferon-alpha and interleukin-2 to conventional chemotherapy have also been actively investigated. This paper reviews the various approaches taken against disseminated melanoma employing systemic chemotherapy.