Systemic chemotherapy for the treatment of metastatic melanoma.

Several new treatment regimens for patients with metastatic melanoma have shown improved overall response rates when compared with the historical results with dacarbazine as a single agent. These regimens have included the addition of tamoxifen to cisplatin-containing regimens or the combination of chemotherapeutic agents with biologicals. Despite the seeming improved overall response rates, the complete remission rates remain less than 20%. Additionally, relatively few new agents have shown significant activity against melanoma cell lines, offering promise for future treatments. In the midst of all this pessimism, however, we should recognize that we have learned important information from these studies that will provide us with the basis for the next generation of clinical trials. We should continue our aggressive search for new agents or combinations of agents that will improve the outlook for our patients while continuing the laboratory studies that may provide insight into new mechanisms for attacking malignant cells.