Buzaid A C, Murren J
Department of Medicine, Yale University School of Medicine, New Haven, CT 06510.
Int J Clin Lab Res. 1992;21(3):205-9. doi: 10.1007/BF02591647.
Systemic chemotherapy for the treatment of metastatic melanoma remains disappointing. Nor new single agent has demonstrated promising results. The combination of cisplatin, decarbazine, carmustine, and tamoxifen appears to be one of the most active regimens with an overall response rate approaching 50%. In some patients, responses have been durable and exceed 3 years. Sequential small phase II trials suggest that tamoxifen is an important component in this combination. The efficacy of the combination of hormonal and chemotherapy, however, needs to be corroborated in a large multicenter phase II trial. In addition, further laboratory and clinical studies are needed to evaluate the role of tamoxifen. Biological response modifiers, such as interleukin-2 and alpha-interferon, have limited activity as single agents, but in combination with cytotoxic agents show some promise and merit further evaluation. Future research should focus on the development of more effective agents, and on the use of aggressive adjuvant and neoadjuvant chemotherapy in high-risk patients with locally advanced disease.
用于治疗转移性黑色素瘤的全身化疗效果仍然令人失望。尚无新的单一药物显示出有前景的结果。顺铂、达卡巴嗪、卡莫司汀和他莫昔芬的联合方案似乎是最有效的方案之一，总体缓解率接近50%。在一些患者中，缓解持续且超过3年。序贯小型II期试验表明他莫昔芬是该联合方案的重要组成部分。然而，激素疗法与化疗联合的疗效需要在大型多中心II期试验中得到证实。此外，需要进一步的实验室和临床研究来评估他莫昔芬的作用。生物反应调节剂，如白细胞介素-2和α-干扰素，作为单一药物活性有限，但与细胞毒性药物联合使用显示出一些前景，值得进一步评估。未来的研究应集中在开发更有效的药物，以及在局部晚期疾病的高危患者中使用积极的辅助和新辅助化疗。
