The use of BELD combination chemotherapy (bleomycin, vindesine, CCNU, and DTIC) in advanced malignant melanoma.

Twenty-one patients with Stage III malignant melanoma have been treated with a 5-day quadruple chemotherapy regime (BELD) comprising bleomycin 15 mg subcutaneously on days 1 and 4, vindesine (Eldesine) 3 mg/m2 intravenously on days 1 and 5, CCNU (lomusine) 80 mg/m2 orally on day 1, and DTIC 200 mg/m2 intravenously on days 1 through 5. Twenty patients were evaluated after two cycles. Three (15%) are in complete remission 12, 16, and 53 weeks after therapy, respectively, and six (30%) experienced worthwhile partial remissions. This combined response rate of 45% is considerably better than that seen in single- or dual-agent chemotherapy. Toxicity was acceptable, and several patients received their therapy on an outpatient (ambulatory) basis. The one nonevaluable patient had radiotherapy for an isolated spinal metastasis and two courses of BELD. She is well and pain- and disease-free 56 weeks later. The median survival for all treated patients is 43 weeks, and the median follow-up time is now 63 weeks.