Chemotherapy of Malignant Melanoma with Dimethyl Triazeno lmidazole Carboxamide (DITC) and Nitrosourea Derivatives (BCN U, CCNU)

Abstract

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.

Management and outcome of metastatic melanoma during pregnancy

“…In our study, chemotherapy was delayed in cases where the maternal status was fragile and required rapid caesarean section to rescue the baby. Taking into account our patients, 36 administrations of dacarbazine during pregnancy have been documented, eight during the first trimester, 8,11,26–28 and 28 during the second or third trimester 9,10,27–32 . Congenital abnormalities were observed during the first trimester exposure in two cases and consisted of isolated microphthalmos with secondary severe hypermetropia, 11 and in a unilateral floating thumb malformation 28 .…”

Malignant Melanoma: A Review

“…The studies of Johnson and Jacobs (1971) and Nathanson et al (1971) have shown that DTIC has a greater effect in females than in males. On the negative side, Hill et al (1974) studied 107 patients after surgery for malignant melanoma by random assignment to receive or not to receive DTIC. No significant difference was found in the average survival times between the treated and the untreated groups.…”

Leptomeningeal melanoma in childhood

“…Dacarbazine alone produced objective responses in 29% of patients in a series of 80 consecutive cases of metastatic melanoma,48 and it rapidly became the standard against which other agents were judged. By 1975, >800 patients had been treated, with an overall response rate of 25% 49.…”