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Phase II randomized study of dacarbazine, carmustine, cisplatin and tamoxifen versus dacarbazine alone in advanced melanoma patients.

Abstract

This randomized phase II trial was performed to define the activity and toxicity of the combination of dacarbazine (DTIC), carmustine (BCNU), cisplatin (DDP) and tamoxifen (DBDT regimen) versus DTIC alone in patients with metastatic melanoma. Sixty patients with metastatic melanoma were randomly assigned to receive BCNU 150 mg/m2 intravenously (i.v.) on day 1, cisplatin 25 mg/m2 i.v. daily on days 1 to 3, DTIC 220 mg/m2 i.v. daily on days 1 to 3 and tamoxifen 160 mg orally daily for 7 days prior to chemotherapy (DBDT arm; arm A). Treatment cycles were repeated every 28 days, while BCNU was given every two cycles. The DTIC arm (arm B) patients received DTIC alone 1200 mg/m2 i.v. on day 1, repeated every 21 days. Patients were evaluated every two cycles; responding patients continued the treatment for a maximum of 12 cycles. The overall response rate was 26% in the DBDT arm and 5% in the DTIC arm. Complete responses were 2.5% for DBDT and 0% for DTIC. The median progression-free survival and the median survival were 4 and 9 months, respectively for DBDT, and 2 and 7 months for DTIC. DBDT was associated with significant haematological toxicity: 33% of the patients experienced a grade III or IV neutropenia and 28% a grade III or IV thrombocytopenia. In conclusion, the overall response rate obtained with DBDT was greater than that obtained with DTIC alone; however, this combination increases toxicity with limited impact on overall survival.

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  • Authors+Show Affiliations

    ,

    Department of Medical Oncology, Padova Hospital, Azienda Ospedaliera, Italy. mgaliz@tiscalinet.it

    , , , , , , ,

    Source

    Melanoma research 11:2 2001 Apr pg 189-96

    MeSH

    Adult
    Aged
    Antineoplastic Agents
    Antineoplastic Agents, Alkylating
    Antineoplastic Agents, Hormonal
    Antineoplastic Combined Chemotherapy Protocols
    Carmustine
    Cisplatin
    Dacarbazine
    Disease-Free Survival
    Female
    Follow-Up Studies
    Humans
    Male
    Middle Aged
    Tamoxifen
    Time Factors
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Clinical Trial, Phase II
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11333130

    Citation

    TY - JOUR T1 - Phase II randomized study of dacarbazine, carmustine, cisplatin and tamoxifen versus dacarbazine alone in advanced melanoma patients. AU - Chiarion Sileni,V, AU - Nortilli,R, AU - Aversa,S M, AU - Paccagnella,A, AU - Medici,M, AU - Corti,L, AU - Favaretto,A G, AU - Cetto,G L, AU - Monfardini,S, PY - 2001/5/3/pubmed PY - 2001/9/28/medline PY - 2001/5/3/entrez SP - 189 EP - 96 JF - Melanoma research JO - Melanoma Res. VL - 11 IS - 2 N2 - This randomized phase II trial was performed to define the activity and toxicity of the combination of dacarbazine (DTIC), carmustine (BCNU), cisplatin (DDP) and tamoxifen (DBDT regimen) versus DTIC alone in patients with metastatic melanoma. Sixty patients with metastatic melanoma were randomly assigned to receive BCNU 150 mg/m2 intravenously (i.v.) on day 1, cisplatin 25 mg/m2 i.v. daily on days 1 to 3, DTIC 220 mg/m2 i.v. daily on days 1 to 3 and tamoxifen 160 mg orally daily for 7 days prior to chemotherapy (DBDT arm; arm A). Treatment cycles were repeated every 28 days, while BCNU was given every two cycles. The DTIC arm (arm B) patients received DTIC alone 1200 mg/m2 i.v. on day 1, repeated every 21 days. Patients were evaluated every two cycles; responding patients continued the treatment for a maximum of 12 cycles. The overall response rate was 26% in the DBDT arm and 5% in the DTIC arm. Complete responses were 2.5% for DBDT and 0% for DTIC. The median progression-free survival and the median survival were 4 and 9 months, respectively for DBDT, and 2 and 7 months for DTIC. DBDT was associated with significant haematological toxicity: 33% of the patients experienced a grade III or IV neutropenia and 28% a grade III or IV thrombocytopenia. In conclusion, the overall response rate obtained with DBDT was greater than that obtained with DTIC alone; however, this combination increases toxicity with limited impact on overall survival. SN - 0960-8931 UR - https://www.unboundmedicine.com/medline/citation/11333130/Phase_II_randomized_study_of_dacarbazine_carmustine_cisplatin_and_tamoxifen_versus_dacarbazine_alone_in_advanced_melanoma_patients_ L2 - http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0960-8931&volume=11&issue=2&spage=189 ER -