Combined carboplatin and cytosine arabinoside in metastatic melanoma refractory to dacarbazine.

This is a preliminary report on the efficacy and toxicity of the combination chemotherapy regimen with carboplatin and cytosine arabinoside in dacarbazine-resistant metastatic melanoma. Patients were considered eligible in the presence of measurable disease sites, an ECOG performance status of 2 or less, a life expectancy of at least 2 months, and prior dacarbazine treatment. The planned schedule consisted of cytosine arabinoside (150 mg/m2 intravenously plus 50 mg subcutaneously), followed by a rapid infusion of carboplatin (350 mg/m2 on day 1). Courses were administered every 3 weeks according to hematologic recovery. Twenty-one consecutive patients were evaluable for activity and toxicity, the response rate was 19% (95% confidence interval, 5-42%). There was no complete remission. Toxicity was tolerable being myelosuppression the main side effect. In conclusion, the combination of carboplatin and cytosine arabinoside has limited activity as a salvage treatment in melanoma patients failing on dacarbazine chemotherapy. Moreover, the regimen is well tolerated and easy to administer in an outpatient setting.