Does chemosensitivity-assay-directed therapy have an influence on the prognosis of patients with malignant melanoma stage IV? ..

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Eur J Med Res. 2007 Oct 30;12(10):497-502.

Does chemosensitivity-assay-directed therapy have an influence on the
prognosis of patients with malignant melanoma stage IV? A retrospective
study of 14 patients with malignant melanoma stage IV.

 
Doerler M, Hyun J, Venten I, Potthoff A, Bartke U, Serova K, Hoextermann S, Altmeyer P, Brockmeyer NH.
 
Department of Dermatology, Ruhr-University Bochum, Germany.
OBJECTIVE:
To evaluate the efficacy of chemosensitivity-testing directed
chemotherapy in comparison with empirically chosen therapy regimens in
patients with malignant melanoma stage IV.

PATIENTS AND METHODS:
Retrospective study including 14 patients with histologically confirmed
malignant melanoma and diagnosis of stage IV disease by routine
diagnostic procedures. Patients in group A (n = 7) were treated
according to their individual chemosensitivity testing results, whereas
patients in group B (n = 7) received empirically chosen treatment
regimens. Chemosensitivity testing was performed using a nonclonogenic
ATP-TCA assay. For statistical analysis the Kaplan-Meier method was
used to calculate survival curves. The log-rank test was performed to
compare the overall survival according to treatment group, LDH level in
serum and AJCC-category. To compare the distribution of sex, LDH level
in serum and AJCC-category between the treatment groups, the Fisher
exact test was used.
RESULTS: The median overall survival of group A
exceeded the median overall survival of group B by 8 versus 3 months,
respectively with a median overall survival of 5 months for the whole
study population. LDH level in serum at study entry showed a strong
correlation with overall survival, with normal LDH levels leading to a
statistically significant longer survival (p = 0.006 for the log-rank
test, respectively). Moreover, stage AJCC M1a/b yielded to a better
prognosis compared with stage AJCC M1c (log-rank test p = 0.066; not
statistically significant).
CONCLUSION: Chemosensitivity-assay directed
therapy might be a useful tool in determining the optimized
chemotherapeutic drug or drug combination in the individual patient and
might contribute to a better prognosis in patients with metastatic
melanoma stage IV.