Chemotherapy for metastatic melanoma was performed in 80 consecutive evaluable patients. DTIC, BCNU and CCNU produced responses in 28% of patients, alone or in combination with each other. Three of 62 patients treated with DTIC remain free of tumor, off therapy at 18-36 months following objective regression of metastases. Chemotherapy with commercially available drugs continued to be uniformly unsuccessful. DTIC was used successfully in treatment of extensive extracranial disease, including one patient with metastatic melanoma during pregnancy. Cerebral metastases were the sole or major cause of death in 8/9 patients who relapsed following control with DTIC for nine months or longer, and one patient developed a carcinoma of the breast following therapy with DTIC and BCNU. Remission was induced in two patients with intralesional BCG, after prior attempts to control metastases with DTIC and combination chemotherapy.
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