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Combination chemotherapy with dacarbazine, cisplatin, carmustine, and tamoxifen was compared to dacarbazine alone in 240 patients with metastatic melanoma. The average survival was 7 months for the dacarbazine arm and 6.3 months for the combination chemotherapy arm. There were no complete responses in this study while 17% in the combination arm and 10% in the dacarbazine arm had partial responses. Toxicities were greater in the combination arm. These physicians concluded that this combination chemotherapy treatment regimen was not better than single-drug chemotherapy for patients with newly diagnosed melanoma. The lack of complete responses in this study brings into question whether patients should receive chemotherapy alone for initial disease or be enrolled in trials containing biologic agents such as alfa interferon and/or interleukin-2. (

Proceedings of American Society of Clinical Oncology, Vol 18, Abstract 2068, 1999)

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