TITLE:
High Response Rate to Second-Line Combination Antiangiogenic Chemotherapy in Patients with Metastatic Melanoma
AUTHORS:
Ozan Haase, Ozan Angün, Ewan A. Langan, Franziska Hübner, Florian M. Vogt, Christoph Thorns, Detlef Zillikens, Patrick Terheyden
KEYWORDS:
Melanoma, Cisplatin, Carboplatin, Bevacizumab, Response, Angiogenesis
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.12,
November
11,
2016
ABSTRACT: Objectives: Despite the array of new treatment
strategies for the management of metastatic melanoma, the prognosis remains
poor when immune checkpoint inhibition and targeted therapy options are
exhausted. The antiangiogenic monoclonal antibody bevacizumab has documented
its efficacy in the treatment of several solid tumors, when used in combination
with standard chemotherapy. Phase II studies and case series have led to the
speculation that it may also improve the prognosis when used in stage IV
melanoma. Therefore, we investigated the influence of bevacizumab, combined
with a platinum-based chemotherapy, in the treatment of melanoma and sought to
identify prognostic factors affecting the response. Methods: Eight patients
with metastatic melanoma, with documented progress after at least one previous
therapy, received bevacizumab (5 mg/kg intravenously every two weeks) in
combination with cisplatin (100 mg/m2 every four weeks) and
carboplatin (200 mg/m2 every four weeks). The therapy was continued
until renewed disease progression occurred. The response rate, progression-free
and overall survival, and toxicity were evaluated. Results: We observed
complete remission in two patients (25%) and partial response in an additional
four patients. In one patient, the disease remained stable (total disease
control rate of 87.5%). Only one patient (12.5%) had progressive disease. The
median progression-free survival was 6 months (range 3 - 37 months). The median
overall survival time was 15.5 months (range 6 - 77 months). Every patient
experienced at least one adverse event of grade 3 - 4, most commonly bleeding
associated with severe thrombocytopenia. Conclusion: Our observations indicate
that bevacizumab, in combination with cisplatin and carboplatin, may represent
an effective treatment option for patients with metastatic melanoma and disease
progression.