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Phase II trial of dacarbazine and thalidomide for the treatment of metastatic melanoma.

Abstract

OBJECTIVE

This phase II study evaluated the efficacy and tolerability of dacarbazine in combination with thalidomide in metastatic melanoma patients.

METHODS

Chemotherapy-naïve patients with histologically confirmed, measurable metastatic melanoma with no evidence of brain metastases and adequate hematologic and organ function received dacarbazine (1,000 mg/m(2) i.v. every 3 weeks) and thalidomide (starting dose of 200 mg/day orally at night, escalated every 3 weeks) as tolerated. The primary endpoint was objective tumor response, evaluated after every 3 cycles of treatment. Fifteen patients, age range 29-77 years, were accrued for this study. All had stage IV disease (1 M1a, 5 M1b, 9 M1c). Nine patients had had no prior adjuvant therapy, 6 had received prior immunotherapy. The median number of cycles was 5 (range 1-18), with 8 patients receiving >or=3 cycles. The median thalidomide dose administered was 200 mg/day with a maximum tolerated dose of 400 mg/day.

RESULTS

Of the 13 patients evaluable for response, 1 patient had a partial response, 3 patients had stable disease and 9 patients had progressive disease. No complete responses were seen. Two patients were not evaluable for response: 1 withdrew due to toxicity and 1 died of unrelated causes. Grade III neutropenia, thrombocytopenia and nausea were attributed to dacarbazine. Grade III/IV constipation, peripheral neuropathy, fatigue, edema and rash were attributed to thalidomide.

CONCLUSION

The addition of thalidomide to dacarbazine in metastatic melanoma yielded activity insufficient to proceed with additional trials of this combination. Thalidomide dose escalation beyond 200 mg/day was limited by unacceptable toxicity. Therefore, this combination does not warrant further investigation.

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  • Authors+Show Affiliations

    ,

    Division of Medical Oncology, New York University Cancer Institute, New York University School of Medicine, New York, NY 10016, USA. patrick.ott@nyumc.org

    , , , , ,

    Source

    Chemotherapy 55:4 2009 pg 221-7

    MeSH

    Adult
    Aged
    Antineoplastic Combined Chemotherapy Protocols
    Dacarbazine
    Dose-Response Relationship, Drug
    Female
    Humans
    Male
    Melanoma
    Middle Aged
    Neoplasm Metastasis
    Skin Neoplasms
    Thalidomide

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    19451711