RT Book, Section
A1 Sandhu, Shahneen
A1 Smalley, Keiran
A1 McArthur, Grant
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145756161
T1 Systemic Treatment for Stage IV Melanoma
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK accesssurgery.mhmedical.com/content.aspx?aid=1145756161
RD 2024/04/20
AB Metastatic  melanoma  continues  to  place  a  substantial  economic  burden  on  western  caucasian  populations  because  of  the  disproportionately  high  incidence  in  young  patients.1  Historically,  the  prognosis  for  patients  with  metastatic  disease  has  been  dismal  with  a  median  overall  survival  (OS)  of  6  to  9  months  and  a  5-year  survival  rate  of  less  than  10%.2  Until  2011,  only  dacarbazine  and  high-dose  interleukin  2  (IL-2)  were  approved  for  the  treatment  of  metastatic  disease.  Dacarbazine  gained  approval  in  1975  for  its  modest  response  rate  of  10%  and  median  OS  of  5.6  to  9.7  months.2,3  Attempts  to  improve  on  this  with  other  cytotoxics  (temozolomide  or  fotemustine),  cisplatin-based  combination  chemotherapy,  biochemotherapy,  and  concurrent  use  of  targeted  agents  with  dacarbazine  resulted  in  marginally  higher  response  rates,  additional  toxicity  but  no  added  survival  advantage  over  single  agent  dacarbazine.3-6  High-dose  IL-2  has  consistently  demonstrated  an  objective  response  rate  (ORR)  of  16%  to  23%  with  durable  complete  responses  seen  in  approximately  5%  to  10%  of  patients.7  High-dose  IL-2,  however,  requires  skilled  inpatient  management,  which  has  largely  restricted  clinical  application  to  a  small  number  of  highly  specialized  centers.