Chemotherapy of metastatic malignant melanoma.Experience with 73 patients

Seventy-three patients with disseminated melanoma were given chemotherapy at the University of California Hospitals, San Francisco. The chemotherapeutic regimens employed in their approximate chronological order over the 9-year period were as follows: 1. pyrimidine nucleosides 5-iodo-2'-deoxyridine (IUDR), 5-fluoro-2'-deoxyuridine (FUDR), or a combination of both; 2. alkylating agents, nitrogen mustard, cyclophosphamide, phenylalanine mustard, or chlorambucil; 3. trimethylcolchicinic acid methyl ether d-tartrate (TMCA); 4. a combination of vincristine and cyclophosphamide; 5. a combination of 1, 3 bis (2-chloroethyl)-, l-nitrosourea (BCNU) and vincristine, and 6. a “miscellaneous” group which included hydroxyurea, cytosine arabinoside, and vinblastine. Objective remissions (50% reduction in tumor size) were observed in 6 patients (20%) treated with TMCA and in 1 patient (4%) treated with phenylalanine mustard. Partial responses were observed in 5 patients (17%) treated with TMCA and in 14 patients (19%) treated with other agents. Toxic effects from TMCA (pancytopenia, stomatitis, nausea and vomiting) were rapidly reversed by stopping the drug. In this series, TMCA proved to be a drug which was easily administered, on an outpatient basis, and produced significant remission rates. It is suggested that TMCA receive more extensive drug trials.