Dacarbazine, Nimustine, Cisplatin and Tamoxifen Combination Chemotherapy (DAC-Tam regimen) for Metastatic Melanoma

Abstract

77 patients with metastatic melanoma in 13 hospitals were treated with DAC-Tam regimen (dacarbazine 220 mg/m² and cisplatin 25 mg/m² intravenously daily on days 1 to 3, nimustine 60 mg/m² intravenously on day 1, and tamoxifen 20 mg orally daily). We observed tumor response, survival time and toxicity. Result: An overall response rate was 20.7% and complete response rate was 1.3%. Responses have been observed mainly in liver, lung and lymph node metastases. Liver metastases were most effective, the response rate was 33.3%. Patients with single organ metastases were a higher response rate than those with multiple organs metastases. Patients previously exposed to dacarbazine have a lower rate of response to this regimen than those untreated with dacarbazine. The major toxicities were thrombocytopenia, neutropenia, nausea and vomiting. No one developed deep venous thrombosis.