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10th
International Inter University Scientific Meeting
Academy of Studenica
PERSPECTIVES
IN MELANOMA MANAGEMENT
& NANOTECHNOLOGY IN BIOMEDICINE
Organizers:
Institute of Oncology
Sremska Kamenica; Union of Cancer Prevention
Societies of Vojvodina, Novi Sad; Clinic of Oncology, Nis; Institute
for Oncology and Radiology of Serbia, Belgrade Center for Bioengineering,
Faculty of Mechanical Engineering, University of Belgrade
President:
Vladimir Baltic Vice-presidents: Zlata
Janjic, Radan Dzodic, Borislava Nikolin; Djuro Koruga
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THE
EFFECT OF COMBINED CHEMOTHERAPY WITH OR WITHOUT POTENTIATION WITH
INTERFERON ALPHA OR TAMOXIFEN FOR MELANOMA
Pejčić
I, Vrbić S, Filipović S, *Pejčić Lj, Jovanović B, Šćekić M, **Filipović
A.
Clinic for
Oncology, Clinical Ccenter of Niš, Niš, Serbia and Montenegro
* Clinic for Pediatrics, Clinical Center of Niš, Niš, Serbia and
Montenegro
** Medicine Ffaculty of Niš, Niš, Serbia and Montenegro
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ABSTRACT
BACKGROUND:
Metastatic melanoma has shown only limited responsiveness to
chemotherapy or immunotherapy. The most commonly used single-agent
chemotherapy comes from the nitrosourea group of agents and provides
response rates of less than 20%. Several cytotoxic agents have been
combined with no dramatic benefit. The incorporation of tamoxifen
or interferon in chemotherapy regimens has proven effective in some
trials.
METHODS: From July 1998 to March 2002, 45 patients with metastatic
melanoma were enrolled for the study. None of the patients had previously
received chemotherapy. The aim of the study was to compare the activity
of three combined regimens: CVD (cisplatin, vinblastine, dacarbazine)
chemotherapeutic combination, CVD with interferon (IFN) alpha-2
- biochemotherapy, and CVD with tamoxifen. The study was conducted
as a single center, controlled, prospective, randomized phase II
study directed toward the disease.
RESULTS: The best response rate (RR) was observed in the
CVD+IFN (6/15) group related to the CVD (4/15) and CVD+TAM (3/15)
groups, without significant difference though. In 29 patients with
1 to 2 metastatic lesions, RR was 44.82% (CR-1, PR-12, SD-13, PD-3),
while in 16 patients with 3 or more metastatic lesions RR was 0.0
% (CR-0, PR-0, SD-9, PD-7). The difference was statistically significant
(p<0.005). The best responding metastatic sites were the lymph nodes
(in 10 patients), but patients with lung, skin and liver lesions
also responded. All patients experienced mild adverse effects. No
treatment-related deaths occurred. The median survival was 12, 12,
and 11 months in CVD+IFN, CVD and CVD+TAM group, respectively. Time
to progression was about 8 months in all treated groups.
CONCLUSION: Combined chemotherapy, biochemotherapy or chemohormonal
therapy all showed some activity in metastatic melanoma. However,
it is not yet possible to define standard therapy for this disease.
Due to a limited number of patients evaluated so far in this investigation
the results should be clearer and more conclusive with larger cumulative
number of cases enrolled. |
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Keywords:
Melanoma; Neoplasm Metastasis; Treatment Outcome; Tamoxifen;
Inteferon Alfa-2A |
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