Serum S-100 has prognostic significance in malignant melanoma.

BACKGROUND: Pretreatment serum values of S-100 and NSE were compared in patients with malignant melanoma. MATERIALS AND METHODS: Pretreatment serum levels of patients with malignant melanoma were analysed for stage of disease and survival. RESULTS: S-100 pretreatment serum values seem highly specific, but have low sensitivity. CONCLUSION: Further evaluation is needed with an assay with improved sensitivity.

Topical dinitrochlorobenzene combined with systemic dacarbazine in the treatment of recurrent melanoma.

Fifty-nine selected patients with recurrent melanoma (37 locoregional and 22 locoregional and haematogenic) were treated with a combination of topical dinitrochlorobenzene (DNCB) and systemic dacarbazine (DTIC). The observations were analysed retrospectively. Fifteen patients (25%) (one third with distant spread) experienced a complete response, with a median duration of 10 months (range 3-210 months). Five of these patients, three of them with haematogenic disease, showed prolonged disease-free survival (85, 156, 170, 177 and 210 months). Seven patients (12%) obtained a partial response, and no response was seen in the remaining 37 patients (63%). In the presence of a severe local reaction to topical DNCB application the median survival was 12 months compared with 7 months in cases with a slight or moderate local reaction (P=0.0013). Patients showing a response to the DNCB-DTIC combination had a median survival of 18 months versus 7 months for the non-responders (P<0.0003). In view of the prolonged survival in five patients, this combined treatment schedule yields promising results in the treatment of selected melanoma patients with cutaneous recurrences, whether or not these are associated with other metastases.

Report of a symposium on: diagnosis and treatment of cutaneous head and neck melanoma.

A series of presentations and discussions was held during a symposium on the diagnosis and treatment of cutaneous head and neck melanoma. The purpose of this meeting was to define certain guidelines on diagnosis and treatment of head and neck melanoma. The results of this symposium are summarized and condensed in this report. Recommendations are made for diagnostic strategies and for treatment. It is indicated that research efforts in immunology need to be expanded to develop rational immunotherapy.

Feasibility study of high-dose carboplatin and etoposide in the salvage treatment of testicular cancer.

Eleven patients with testicular cancer, either relapsing after or refractory to cisplatin-based chemotherapy, underwent salvage chemotherapy with high-dose carboplatin (800 mg/m2 on day 1) and high-dose etoposide (500 mg/m2 on days 1, 3 and 5). A total of 21 courses were administered. The major toxicity consisted of profound myelosuppression. There were two toxic deaths, both caused by infection during neutropenia. Bone marrow recovery was usually complete around day 26 (range 19-129). Other toxicities included mild mucositis, nausea and vomiting, and alopecia. No significant neurotoxicity or hearing loss were observed and only one patient had a moderate decrease in renal function. Nine of ten evaluable patients responded, with one complete remission, 6 partial remissions with normalization of tumor markers, and two partial remissions with over one log decrease of tumor markers. The duration of these remissions was not evaluable, since only three evaluable and responding patients did not receive additional therapy after HD-CE. All three relapsed after discontinuing chemotherapy. HD-CE has activity in relapsing or refractory testicular cancer and can be administered without bone marrow support. The regimen may thus be suitable to be used as a remission induction regimen prior to consolidation with intensive chemotherapy and autologous bone marrow transplantation.