Vuoristo Meri-Sisko, Vihinen Pia, Skyttä Tanja, Tyynelä Kristiina, Kellokumpu-Lehtinen Pirkko
Department of Oncology, Tampere University Hospital, P.O.B 2000, 33521 Tampere, Finland.
Anticancer Res. 2009 May;29(5):1755-9.
The treatment results of metastatic melanoma are miserable if the tumor has spread beyond the soft tissue and lung, in particular, if dacarbazine (DTIC)-based therapy has failed. Platinum analogs and vinca alkaloids have shown some activity in melanoma. Interleukin-2 (IL-2) may augment the efficacy of chemotherapy.
A prospective phase II pilot study was conducted to evaluate the efficacy and tolerability of a regimen which contained carboplatin (450 mg/m(2) on day 1), vinorelbine (30 mg/m(2) on day 1) and IL-2 (9 MU subcutaneously once daily on days 2-5 and 9-12) in metastatic melanoma. Twenty-two patients (11 men, 11 women; median age 56 years) were eligible, of whom 13 had cutaneous, 6 ocular and 3 unknown primary melanoma. Seventeen patients (77%) had liver metastases and an equal number had received prior chemotherapy and/or interferon-alfa for recurrent disease.
One partial response was recorded, yielding a response rate of 4.5% . Nine patients had stable disease for a median of 6.0 months (range 3.0-8.6 months). The median time to progression for all patients was 1.8 months (range 0.7-8.6 months) and the median survival was 7.2 months (range 1.4-42.0 months). Toxicity was moderate but manageable. Myelosuppression was the most significant adverse event.
This regimen may offer clinical benefit for melanoma patients with poor prognosis as second-line therapy after DTIC has failed.
如果转移性黑色素瘤已扩散至软组织和肺部以外，尤其是基于达卡巴嗪（DTIC）的治疗失败时，其治疗结果很不理想。铂类类似物和长春花生物碱在黑色素瘤中已显示出一定活性。白细胞介素-2（IL-2）可能会增强化疗疗效。
开展了一项前瞻性II期试验性研究，以评估一种方案的疗效和耐受性，该方案包含卡铂（第1天450mg/m²）、长春瑞滨（第1天30mg/m²）和IL-2（第2 - 5天和第9 - 12天每天皮下注射9MU）用于治疗转移性黑色素瘤。22例患者（11例男性，11例女性；中位年龄56岁）符合条件，其中13例为皮肤黑色素瘤，6例为眼部黑色素瘤，3例原发灶不明。17例患者（77%）有肝转移，且同样数量的患者曾接受过针对复发性疾病的化疗和/或干扰素-α治疗。
记录到1例部分缓解，缓解率为4.5%。9例患者病情稳定，中位时间为6.0个月（范围3.0 - 8.6个月）。所有患者的中位疾病进展时间为1.8个月（范围0.7 - 8.6个月），中位生存期为7.2个月（范围1.4 - 42.0个月）。毒性为中度但可控制。骨髓抑制是最显著的不良事件。
该方案作为DTIC治疗失败后的二线治疗，可能为预后不良的黑色素瘤患者带来临床益处。
