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The effect of temozolomide-based chemotherapy in patients with cerebral metastases from melanoma.

Abstract：

:Cerebral metastases from melanoma are correlated with a poor prognosis. Temozolomide is an oral alkylating agent that can cross the blood-brain barrier and in phase II and III trials, patients with advanced metastatic melanoma achieved overall response rates of 13 to 21%. The present study evaluated the efficacy and toxicity of temozolomide-based chemotherapy in patients with cerebral metastases from melanoma. Twenty-five patients (median age 48 years) with histologically confirmed stage IV melanoma and cerebral metastases treated with temozolomide-based chemotherapy. 10 patients received temozolomide plus docetaxel, nine patients temozolomide plus cisplatin and six patients temozolomide as single agent. Six patients achieved an objective response (24%). All responses were partial. The disease was stable in five patients (20%) and 13 patients progressed (52%). The median response duration was 6.9 months (range 1.8 to 16 months). The median time to progression (TTP) for all patients was 2 months, compared with a median TTP of 3.9 months, among responders and a median TTP of 1.8 months, for patients who remained stable or progressed (P<0.0001). The median survival time for the entire patient population was 4.7 months. The median survival for responders was 5.5 months and for non-responders was 3.6 months. The difference was statistically significant (P<0.05). The toxicity was mild. The most frequently reported adverse event were myelotoxicity and nausea and vomiting. Four patients developed grade 3/4 leukopenia, two grade 4 neutropenia, and one patient developed grade 3 thrombocytopenia. There was no treatment discontinuation caused by toxicity. Temozolomide-based chemotherapy may have a role in patients with cerebral metastases from melanoma. Further exploration is required. Toxicity was manageable.

journal_name

Melanoma Res

journal_title

Melanoma research

authors

Bafaloukos D,Tsoutsos D,Fountzilas G,Linardou H,Christodoulou C,Kalofonos HP,Briassoulis E,Panagiotou P,Hatzichristou H,Gogas H

doi

10.1097/01.cmr.0000136707.60108.ab

subject

Has Abstract

pub_date

2004-08-01 00:00:00

pages

289-94

issue

eissn

0960-8931

issn

1473-5636

pii

00008390-200408000-00009

journal_volume

pub_type

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The effect of temozolomide-based chemotherapy in patients with cerebral metastases from melanoma.