Vinblastine, bleomycin, and cis-platinum for the treatment of metastatic malignant melanoma. National Cancer Institute of Canada Melanoma Group.

Sixty-five patients with metastatic melanoma were treated with vinblastine, bleomycin, and cis-diammine dichloroplatinum (VBD). Sixty-four patients were evaluable for response and toxicity. Twelve (19%) of 64 responded. Three patients (5%) achieved a complete response and nine patients (14%) achieved a partial response. Eleven (22%) of 50 previously untreated patients responded. Nine (30%) of 30 women responded while only three (9%) of 34 men responded. All three complete responses were in previously untreated women. Ten (19%) of 52 patients with visceral metastases responded and two (17%) of 12 patients with soft tissue metastases responded. The duration of complete responses was 23, 25, and 32 weeks. The median duration of the partial responses was 20 weeks (range, 12-28 weeks). Major toxicity was encountered. Leukocyte counts less than 1.0 X 10(9)/L were seen in 27% of the patients. There was one sepsis-related death. Platelet counts less than 50 X 10(9)/L were seen in 22% of patients. Mucositis was common. VBD can cause regression of advanced visceral metastatic disease but the low response rate, short duration of response, and major toxicity abrogates most of its utility as initial treatment for metastatic melanoma.