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AMSTERDAM Here's just how little progress has occurred in the systemic treatment of metastatic melanoma over the last 3 decades: Today the best therapeutic option for patients with advanced melanoma is to enroll them in a clinical trial of an investigational drug, Dr. Mark R. Middleton said at the 11th World Congress on Cancers of the Skin.
The standard treatment of advanced melanoma has for many years been single-agent dacarbazine (DTIC). None of the numerous multidrug combinations of chemotherapeutic agents or chemotherapeutic agents plus cytotoxic or biologic agents that have been tested have proved more effective than DTIC, only more toxic, he said.
Over the years, though, oncologists have come to realize that they have overestimated how good a drug DTIC is, said Dr. Middleton, a medical oncologist at Cancer Research UK and the University of Oxford (England).
Indeed, while decades-old studies suggested 20% of patients with advanced melanoma experience an objective tumor response to DTIC, more recent large multicenter studies indicate that the true figure is between 1 in 7 and 1 in 10, with no evidence DTIC offers any improvement over supportive care in terms of overall survival, he said at the congress, which was cosponsored by the Skin Cancer Foundation and Erasmus University.
This discouraging assessment isn't just one oncologist's view. Dr. Alexander M.M. Eggermont noted during his presentation that the Dutch Cancer Society recently issued an advisory that the No. 1 option in patients with advanced melanoma is to enter them into any new drug development trial, even a phase I trial.
"So phase I studies are the preferred option in stage IV melanoma patients, rather than giving them the usual stuff. I think that's a very important message because that's really what we need to move the field forward," added Dr. Eggermont, professor and head of surgical oncology at Erasmus University Medical Center, Rotterdam, the Netherlands, and president-elect of the Federation of European Cancer Societies.
AMSTERDAM Here's just how little progress has occurred in the systemic treatment of metastatic melanoma over the last 3 decades: Today the best therapeutic option for patients with advanced melanoma is to enroll them in a clinical trial of an investigational drug, Dr. Mark R. Middleton said at the 11th World Congress on Cancers of the Skin.
The standard treatment of advanced melanoma has for many years been single-agent dacarbazine (DTIC). None of the numerous multidrug combinations of chemotherapeutic agents or chemotherapeutic agents plus cytotoxic or biologic agents that have been tested have proved more effective than DTIC, only more toxic, he said.
Over the years, though, oncologists have come to realize that they have overestimated how good a drug DTIC is, said Dr. Middleton, a medical oncologist at Cancer Research UK and the University of Oxford (England).
Indeed, while decades-old studies suggested 20% of patients with advanced melanoma experience an objective tumor response to DTIC, more recent large multicenter studies indicate that the true figure is between 1 in 7 and 1 in 10, with no evidence DTIC offers any improvement over supportive care in terms of overall survival, he said at the congress, which was cosponsored by the Skin Cancer Foundation and Erasmus University.
This discouraging assessment isn't just one oncologist's view. Dr. Alexander M.M. Eggermont noted during his presentation that the Dutch Cancer Society recently issued an advisory that the No. 1 option in patients with advanced melanoma is to enter them into any new drug development trial, even a phase I trial.
"So phase I studies are the preferred option in stage IV melanoma patients, rather than giving them the usual stuff. I think that's a very important message because that's really what we need to move the field forward," added Dr. Eggermont, professor and head of surgical oncology at Erasmus University Medical Center, Rotterdam, the Netherlands, and president-elect of the Federation of European Cancer Societies.
AMSTERDAM Here's just how little progress has occurred in the systemic treatment of metastatic melanoma over the last 3 decades: Today the best therapeutic option for patients with advanced melanoma is to enroll them in a clinical trial of an investigational drug, Dr. Mark R. Middleton said at the 11th World Congress on Cancers of the Skin.
The standard treatment of advanced melanoma has for many years been single-agent dacarbazine (DTIC). None of the numerous multidrug combinations of chemotherapeutic agents or chemotherapeutic agents plus cytotoxic or biologic agents that have been tested have proved more effective than DTIC, only more toxic, he said.
Over the years, though, oncologists have come to realize that they have overestimated how good a drug DTIC is, said Dr. Middleton, a medical oncologist at Cancer Research UK and the University of Oxford (England).
Indeed, while decades-old studies suggested 20% of patients with advanced melanoma experience an objective tumor response to DTIC, more recent large multicenter studies indicate that the true figure is between 1 in 7 and 1 in 10, with no evidence DTIC offers any improvement over supportive care in terms of overall survival, he said at the congress, which was cosponsored by the Skin Cancer Foundation and Erasmus University.
This discouraging assessment isn't just one oncologist's view. Dr. Alexander M.M. Eggermont noted during his presentation that the Dutch Cancer Society recently issued an advisory that the No. 1 option in patients with advanced melanoma is to enter them into any new drug development trial, even a phase I trial.
"So phase I studies are the preferred option in stage IV melanoma patients, rather than giving them the usual stuff. I think that's a very important message because that's really what we need to move the field forward," added Dr. Eggermont, professor and head of surgical oncology at Erasmus University Medical Center, Rotterdam, the Netherlands, and president-elect of the Federation of European Cancer Societies.