Results of RT-PCR for tyrosinase mRNA in sentinel lymph nodes from patients with localized melanoma

• Autores: Ramón Sousa Domínguez, José Ignacio Mayordomo Cámara, Elena Filipovich, Antonio Güemes Sánchez, Javier Banzo Marraco, Susana Puig Sardá, Enrique Prats Rivera, Jesús Lázaro, Paula Razola Alba, Raquel Andrés Conejero, Alejandro Tres Sánchez
• Localización: Revista de oncología: Publicación oficial de la Federación de Sociedades Españolas de Oncología y del Instituto Nacional de Cancerología de México, ISSN 1575-3018, Vol. 5, Nº. 4 (mayo), 2003, págs. 199-206
• Idioma: inglés
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• Resumen

  • Background. Significant activity (50% objective responses) plus a small fraction of long term survivors have been reported in pilot trials of chemoimmunotherapy (CT-IT) for disseminated melanoma. Requirement for hospitalization is a major inconvenience.

    Aims. To assess the feasibility of fully ambulatory CT-IT with single-day cisplatine+dacarbacine (DTIC) combined with subcutaneous interleukin-2 +interferon-a for patients with metastatic melanoma in a multicenter phase II trial.

    Patients and methods. Courses, to be repeated every 21 days, included cisplatin 80 mg/m2 and DTIC 800 mg/m2, both i.v. on day one, plus subcutaneous injections of interleukin-2, 9 million/m2 IU, day two to 5 and interferon-a, 5 million m2 IU day one to 5. No corticosteroids were allowed except for 20 mg dexamethasone before cisplatine on day one for antiemesis. After 6 courses patients without progression received 6 additional courses of IT alone.

    Results. Forty four patients with metastasic melanoma have been treated. Male/female: 30/14. Median age: 47 years. Performance status (ECOG): 1 (0-2). Full doses of therapy have been delivered in 224 courses. Toxicity was acceptable: grade 3 toxicity included nausea (6% of courses), vomiting (10%), fever (1%), neutropenia (1%), anemia (0.8%), asthenia (2%), elevation of transaminases (0.8%) and elevation of serum creatinine (0.8%). Response (39 patients evaluable after three or more courses; rest too early): complete response 4 patients (10.2%); partial response 13 patients (33%); stable disease 8 patients (20.5%); progression 14 patients (35.8%). With median follow-up of 20 months or to death, median survival was 11.6 months.

    Conclusions. The activity and limited toxicity of this regimen allow its ambulatory use. The superiority of CT-IT over each modality alone remains to be confirmed.