Chemoimmunotherapy for metastatic malignant melanoma using vincristine (NSC-67574), DTIC (NSC-45388) and bacillus Calmette-Guerin

Abstract

Forty-seven patients with stage IV malignant melanoma were treated with pulses of Vincristine and DTIC. Intercalated, monthly BCG was administered by multiple puncture gun. No patient exclusions were made. The response rate was 38%; all complete responders (8.5%) were metastatic to skin and nodes only. The median survival of the responder patient group was 6.7 months (1–21) and 2 months (< 1–47 +) for non-responders. No significant differences were found for response nor survival length between patients grouped according to sex, severity of haematological toxicity, intervals from initial diagnosis to appearance of metastases or to start of therapy. Patients with the higher Karnofsky scores survived longer. No side effects attributable to BCG were noted and no serious haematological toxicity was encountered. Despite a high response rate, survival was disappointing, and represented the presence of metastases in more than one organ system with only a minority (13%) of patients having metastases in ‘favourable’ (skin, node) sites. A full description of metastatic sites and other prognostic features is necessary for future treatment evaluation.