Metastatic melanoma: results of 'classical' second-line treatment with cytotoxic chemotherapies

• Published in: The Journal of dermatological treatment Vol. 25; no. 5; pp. 396 - 400
• Main Authors: Perrin, Christophe, Pracht, Marc, Talour, Karen, Adamski, Henri, Cumin, Isabelle, Porneuf, Marc, Talarmin, Marie, Mesbah, Habiba, Audrain, Odile, Moignet, Aline, Lefeuvre-Plesse, Claudia, Lesimple, Thierry
• Format: Journal Article
• Language: English
• Published: Oslo Informa Healthcare USA on behalf of Informa UK Ltd 01.10.2014; Taylor & Francis
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Biological and medical sciences; chemotherapy; Dermatology; Female; Humans; Male; Medical sciences; melanoma; Melanoma - drug therapy; Melanoma - mortality; metastasis; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Pharmacology. Drug treatments; prognosis; Retrospective Studies; second-line; Skin Neoplasms - drug therapy; Skin Neoplasms - mortality; Skin, nail, hair, dermoskeleton; Survival Analysis; Treatment Failure; Treatment Outcome; Tumors; Tumors of the skin and soft tissue. Premalignant lesions; Young Adult; Chemotherapy; Treatment; Prognosis; second-line; Malignant melanoma; Advanced stage; Second line treatment; melanoma; Malignant tumor; Metastasis; Cancer; Result
• DOI: 10.3109/09546634.2012.697986
• ISSN: 0954-6634

Abstract Background: Metastatic melanoma is one of the most aggressive tumours, with a median survival that does not exceed 12 months. None of the cytotoxic first-line therapies have shown survival benefit in randomised clinical trials. Objective: To describe clinical benefit of second-line cytotoxic chemotherapy in the second line of treatment for metastatic melanoma. Methods: In a retrospective study, we analyse the outcome of patients with metastatic melanoma who had received two lines or more of cytotoxic treatments in four French dermato-oncology departments between 1999 and 2009. Results:We describe the outcomes for 109 patients. Most of these patients received dacarbazine for the first line of chemotherapy and fotemustine for the second line of chemotherapy (67.0 and 64.2%, respectively). A clinical benefit was observed in 24.1% of the patients and overall survival was 4.1 months after the second-line treatment. At least 23.8% of patients suffered from grade 3 or 4 toxicities. The presence of more than two sites of metastasis and an M1c staging according to the AJCC classification represented negative predictive factors of clinical benefit. Conclusion: This study shows the modest benefit of a second line of cytotoxic chemotherapy in a nonselected population. If eligible, these patients should be proposed for ongoing clinical trials or for targeted therapies.