TY - JOUR
T1 - Pilot study of preoperative chemotherapy with cisplatin, vinblastine, and dacarbazine in patients with local‐regional recurrence of melanoma
AU - Buzaid, Antonio C.
AU - Legha, Sewa S.
AU - Balch, Charles M.
AU - Ross, Merrick
AU - Ring, Sigrid
AU - Plager, Carl
AU - Papadopoulos, Nicholas E.
AU - El‐Naggar, Adel K.
AU - Benjamin, Robert S.
PY - 1994/11/1
Y1 - 1994/11/1
N2 - Background. Because the prognosis of patients with local‐regional recurrence of melanoma treated with surgery alone usually is poor, the authors conducted a study designed to determine the efficacy of preoperative chemotherapy using cisplatin, vinblastine, and dacarbazine (CVD) in this patient population. Methods. Eligibility included biopsy‐proven, measurable, and potentially resectable local‐regional disease in the form of lymph node metastases, satellite/in‐transit metastases and/or local recurrence. CVD consisted of cisplatin, 20 mg/m2 intravenously (IV) on days 2‐5; vinblastine, 1.6 mg/m2 IV on days 1‐5; and dacarbazine, 800 mg/ m2 IV on day 1 only, repeated every 3 weeks. Patients usually received two to three courses of CVD and then underwent surgery. Postoperatively, patients who responded continued CVD for a maximum of 8 courses; nonresponders received no further therapy. Results. Of 52 consecutive patients (40 with lymph node involvement and 12 with skin metastases), 5 (10%) achieved a pathologic complete response and 20 (38%) achieved a partial response, for an overall response rate of 48% (95% confidence interval, 34‐62). Of the five patients who achieved a pathologic complete response, three had attained a clinical complete response and one a partial response, and one had stable disease after initial chemotherapy. At a median follow‐up of 54 months (range, 32‐69 months), 38% of the patients remained disease free. Conclusion. Preoperative chemotherapy with CVD has significant activity in local‐regional recurrences of melanoma, resulting in pathologic complete response in 10% of the patients. Because its impact on survival remains unclear, this treatment strategy should currently remain investigational. Preoperative chemotherapy, however, could be offered to certain patients with bulky, borderline resectable, regional disease for whom cytoreduction may make surgery easier or less mutilating.
AB - Background. Because the prognosis of patients with local‐regional recurrence of melanoma treated with surgery alone usually is poor, the authors conducted a study designed to determine the efficacy of preoperative chemotherapy using cisplatin, vinblastine, and dacarbazine (CVD) in this patient population. Methods. Eligibility included biopsy‐proven, measurable, and potentially resectable local‐regional disease in the form of lymph node metastases, satellite/in‐transit metastases and/or local recurrence. CVD consisted of cisplatin, 20 mg/m2 intravenously (IV) on days 2‐5; vinblastine, 1.6 mg/m2 IV on days 1‐5; and dacarbazine, 800 mg/ m2 IV on day 1 only, repeated every 3 weeks. Patients usually received two to three courses of CVD and then underwent surgery. Postoperatively, patients who responded continued CVD for a maximum of 8 courses; nonresponders received no further therapy. Results. Of 52 consecutive patients (40 with lymph node involvement and 12 with skin metastases), 5 (10%) achieved a pathologic complete response and 20 (38%) achieved a partial response, for an overall response rate of 48% (95% confidence interval, 34‐62). Of the five patients who achieved a pathologic complete response, three had attained a clinical complete response and one a partial response, and one had stable disease after initial chemotherapy. At a median follow‐up of 54 months (range, 32‐69 months), 38% of the patients remained disease free. Conclusion. Preoperative chemotherapy with CVD has significant activity in local‐regional recurrences of melanoma, resulting in pathologic complete response in 10% of the patients. Because its impact on survival remains unclear, this treatment strategy should currently remain investigational. Preoperative chemotherapy, however, could be offered to certain patients with bulky, borderline resectable, regional disease for whom cytoreduction may make surgery easier or less mutilating.
KW - chemotherapy
KW - local‐regional
KW - melanoma
KW - preoperative
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U2 - 10.1002/1097-0142(19941101)74:9<2476::AID-CNCR2820740914>3.0.CO;2-Z
DO - 10.1002/1097-0142(19941101)74:9<2476::AID-CNCR2820740914>3.0.CO;2-Z
M3 - Article
C2 - 7923003
AN - SCOPUS:0027947444
SN - 0008-543X
VL - 74
SP - 2476
EP - 2482
JO - Cancer
JF - Cancer
IS - 9
ER -