Long term response to chemotherapy in patients with visceral metastatic melanoma

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Abstract
Eight patients who remain in long term remission 4 to 15 years after chemotherapy for visceral metastatic melanoma are described. These patients were observed among some 1100 patients with visceral melanoma seen at the Sydney Melanoma Unit between 1977 and 1989. Only about one-third of such patients received chemotherapy, almost always with single agent dacarbazine or a nitrosourea. The apparently cured patients did not differ from the overall group of patients with visceral metastases in baseline characteristics, but 6 of the 8 had nodular lung metastases. While the mechanism remains uncertain, one possibility could be that chemotherapeutic agents cause mutations which allow expression of antigenicity in tumour cells. In any case, the fact of occasional exceptionally good responses, perhaps amounting to cure, constitutes an argument for a trial of chemotherapy in patients with visceral metastatic melanoma.