Merimsky O, Inbar M, Gerard B, Chaitchik S
Department of Oncology, Ichilov Hospital, Tel-Aviv, Israel.
Melanoma Res. 1992 Dec;2(5-6):401-6. doi: 10.1097/00008390-199212000-00015.
Although chemotherapy has been generally of limited clinical benefit in the treatment of metastatic malignant melanoma (MMM), fotemustine (FM) is a newly developed drug which is active against this disease. Twenty-four patients with histologically proven MMM were treated with fotemustine, with or without dacarbazine (DITC) according to different phase II trials. In the first schedule, three patients received FM alone on days 1, 8, 15 followed by a 5-week rest period. The second schedule consisted of FM administered on days 1 and 8 alternating with DTIC on days 15 and 16, followed by a 5-week rest period (19 patients). The third schedule, given to two patients, consisted of DTIC followed 4 h later by FM. The overall response rate was 8.3%. Response in those who were treated with alternating drugs, included one partial response (PR) in the brain which lasted 4 months, and one PR in brain metastases with complete response (CR) in lymph nodes for 4 months. Clinical and radiological evidence of regression was observed mainly in brain metastases (22.2%), reflecting the intracerebral activity of the drug. It seems that fotemustine is superior to any other drug currently available in the treatment of these metastases.
尽管化疗在转移性恶性黑色素瘤（MMM）的治疗中临床获益通常有限，但福莫司汀（FM）是一种新开发的对该疾病有效的药物。根据不同的II期试验，24例经组织学证实的MMM患者接受了福莫司汀治疗，部分联合或不联合达卡巴嗪（DITC）。在第一个方案中，3例患者在第1、8、15天单独接受福莫司汀治疗，随后休息5周。第二个方案是第1天和第8天给予福莫司汀，第15天和第16天交替给予达卡巴嗪，随后休息5周（19例患者）。第三个方案用于2例患者，先给予达卡巴嗪，4小时后给予福莫司汀。总缓解率为8.3%。交替使用药物治疗的患者中，有1例脑内部分缓解（PR）持续4个月，1例脑转移灶PR且淋巴结完全缓解（CR）持续4个月。主要在脑转移灶中观察到临床和影像学上的消退证据（22.2%），这反映了该药物的脑内活性。似乎福莫司汀在治疗这些转移灶方面优于目前可用的任何其他药物。
