Tamoxifen vs. non-tamoxifen treatment for advanced melanoma: a meta-analysis

• Published in: International journal of dermatology Vol. 49; no. 10; pp. 1194 - 1202
• Main Authors: Beguerie, Julieta Ruiz, Xingzhong, Jin, Valdez, Raúl P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2010; Blackwell
• Subjects: Antineoplastic Agents, Hormonal - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Dermatology; Humans; Leukopenia - chemically induced; Medical sciences; Melanoma - drug therapy; Melanoma - mortality; Melanoma - pathology; Randomized Controlled Trials as Topic; Sex Factors; Skin Neoplasms - drug therapy; Skin Neoplasms - mortality; Skin Neoplasms - pathology; Tamoxifen - therapeutic use; Thrombocytopenia - chemically induced; Tumors of the skin and soft tissue. Premalignant lesions; Antineoplastic agent; Treatment; Dermatology; Malignant melanoma; Malignant tumor; Comparative study; Tamoxifene; Cancer
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/j.1365-4632.2010.04529.x

Although tamoxifen (TAM) is routinely used in advanced melanoma, it is still uncertain whether evidence exists to support this practice. This review assesses the benefits and harms of systemic therapy with TAM vs. without TAM on response and mortality in patients with advanced melanoma. MEDLINE, The Cochrane Database of Systemic Reviews, The Cochrane Central Register of Controlled Trials, EMBASE and LILACS were searched for randomized controlled trials comparing chemotherapy using and not using TAM in any dose, in patients of any age with advanced melanoma. References lists, databases of ongoing trials and conference proceedings were hand‐searched. All included trials were evaluated for quality assessment. Primary outcomes were response and mortality. Secondary outcomes were hematologic and non hematologic toxicity, treatment‐related mortality and quality of life. A meta‐analysis was performed and results were presented as relative risk with 95% confidence interval. Nine randomized controlled trials met the inclusion criteria. Patients treated with TAM were more likely to respond, with a relative risk 1.36 (95% CI: 1.04–1.77, P = 0.02). However, there was no improvement in 1‐year mortality. The incidence of hematologic toxicity was higher in the TAM group. Subgroup analyses showed that female patients were more likely to respond. Chemotherapies with TAM improve overall and partial response, but do not improve mortality in 1 year in advanced melanoma. Further use of TAM in melanoma should be done only in the context of clinical trials.