Abstract
In-transit metastases occur in approximately 3% of melanoma patients, can be very symptomatic and survival in this group may be prolonged. Regional chemotherapy with melphalan delivered by isolated limb perfusion (ILP) or isolated limb infusion (ILI) are effective treatment options which are generally well tolerated. ILI is a less invasive and simpler alternative to ILP. ILI is tolerated better than ILP, though is probably less effective. Complete response rates are 45- 69% for ILP and 23-44% for ILI. The limb is often warmed to lower temperatures in ILI compared to ILP and the limb becomes progressively more hypoxic and acidotic during ILI, each of these parameters potentially having an effect on outcome. ILP & ILI are used primarily as palliative options when excision of in-transit metastases is unfeasible but can be used as an adjunctive procedure to surgery, for other tumour types such as merkel cell carcinoma, and can be repeated if indicated. For ILI correction of melphalan dose for ideal body weight has been shown to substantially decrease the rates of severe local toxicity while maintaining complete response rates, but overall response rate is reduced. Combination treatment with tumour necrosis factor α has been used with variable outcomes and new combinations with buthionine sulfoximine and ADH-1 are being investigated.
Keywords: Melphalan, Melanoma, Chemotherapy, Regional chemotherapy, Isolated limb infusion, Isolated limb perfusion, intransit metastases, symptomatic, acidotic, tumour necrosis factor, cutaneous papules, systemic toxicity, systemic anticoagulation, myelosuppression, Muscle necrosis
Current Topics in Medicinal Chemistry
Title: Melphalan in Regional Chemotherapy for Locally Recurrent Metastatic Melanoma
Volume: 12 Issue: 1
Author(s): C.L. Defty and J.R. Marsden
Affiliation:
Keywords: Melphalan, Melanoma, Chemotherapy, Regional chemotherapy, Isolated limb infusion, Isolated limb perfusion, intransit metastases, symptomatic, acidotic, tumour necrosis factor, cutaneous papules, systemic toxicity, systemic anticoagulation, myelosuppression, Muscle necrosis
Abstract: In-transit metastases occur in approximately 3% of melanoma patients, can be very symptomatic and survival in this group may be prolonged. Regional chemotherapy with melphalan delivered by isolated limb perfusion (ILP) or isolated limb infusion (ILI) are effective treatment options which are generally well tolerated. ILI is a less invasive and simpler alternative to ILP. ILI is tolerated better than ILP, though is probably less effective. Complete response rates are 45- 69% for ILP and 23-44% for ILI. The limb is often warmed to lower temperatures in ILI compared to ILP and the limb becomes progressively more hypoxic and acidotic during ILI, each of these parameters potentially having an effect on outcome. ILP & ILI are used primarily as palliative options when excision of in-transit metastases is unfeasible but can be used as an adjunctive procedure to surgery, for other tumour types such as merkel cell carcinoma, and can be repeated if indicated. For ILI correction of melphalan dose for ideal body weight has been shown to substantially decrease the rates of severe local toxicity while maintaining complete response rates, but overall response rate is reduced. Combination treatment with tumour necrosis factor α has been used with variable outcomes and new combinations with buthionine sulfoximine and ADH-1 are being investigated.
Export Options
About this article
Cite this article as:
Defty C.L. and Marsden J.R., Melphalan in Regional Chemotherapy for Locally Recurrent Metastatic Melanoma, Current Topics in Medicinal Chemistry 2012; 12 (1) . https://dx.doi.org/10.2174/156802612798919187
DOI https://dx.doi.org/10.2174/156802612798919187 |
Print ISSN 1568-0266 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4294 |
Call for Papers in Thematic Issues
Chemistry Based on Natural Products for Therapeutic Purposes
The development of new pharmaceuticals for a wide range of medical conditions has long relied on the identification of promising natural products (NPs). There are over sixty percent of cancer, infectious illness, and CNS disease medications that include an NP pharmacophore, according to the Food and Drug Administration. Since NP ...read more
Current Trends in Drug Discovery Based on Artificial Intelligence and Computer-Aided Drug Design
Drug development discovery has faced several challenges over the years. In fact, the evolution of classical approaches to modern methods using computational methods, or Computer-Aided Drug Design (CADD), has shown promising and essential results in any drug discovery campaign. Among these methods, molecular docking is one of the most notable ...read more
Drug Discovery in the Age of Artificial Intelligence
In the age of artificial intelligence (AI), we have witnessed a significant boom in AI techniques for drug discovery. AI techniques are increasingly integrated and accelerating the drug discovery process. These developments have not only attracted the attention of academia and industry but also raised important questions regarding the selection ...read more
From Biodiversity to Chemical Diversity: Focus of Flavonoids
Flavonoids are the largest group of polyphenols, plant secondary metabolites arising from the essential aromatic amino acid phenylalanine (or more rarely from tyrosine) via the phenylpropanoid pathway. The flavan nucleus is the basic 15-carbon skeleton of flavonoids (C6-C3-C6), which consists of two phenyl rings (A and B) and a heterocyclic ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Resveratrol and Clinical Trials: The Crossroad from In Vitro Studies to Human Evidence
Current Pharmaceutical Design A Review of Electroporation-based Antitumor Skin Therapies and Investigation of Betulinic Acid-loaded Ointment
Anti-Cancer Agents in Medicinal Chemistry Heterocycle-thioacetic Acid Motif: A Privileged Molecular Scaffold with Potent, Broad-Ranging Pharmacological Activities
Current Pharmaceutical Design Roles of Laminin-332 and α6β4 Integrin in Tumor Progression
Mini-Reviews in Medicinal Chemistry Farnesyltransferase Inhibitors: A Comprehensive Review Based on Quantitative Structural Analysis
Current Medicinal Chemistry Phytochemical-Mediated Glioma Targeted Treatment: Drug Resistance and Novel Delivery Systems
Current Medicinal Chemistry Applications of the Rare Earth Elements in Cancer Imaging and Therapy
Current Nanoscience Cisplatin Properties in a Nanobiotechnological Approach to Cancer: A Mini-Review
Current Cancer Drug Targets Nuciferine Inhibits Skin Cutaneous Melanoma Cell Growth by Suppressing TLR4/NF-κB Signaling
Anti-Cancer Agents in Medicinal Chemistry Renal and Hepatic Transporter Expression in Type 2 Diabetic Rats
Drug Metabolism Letters Biology of Protooncogene c-kit Receptor and Spermatogenesis
Current Pharmacogenomics New Insights about the Potential Application of the Association of Vitamins C (Sodium Ascorbate) and K3 (Menadione) as Auxiliary Therapy in Cancer Treatment
Medicinal Chemistry Reviews - Online (Discontinued) α-Halogenoacrylic Derivatives of Antitumor Agents
Mini-Reviews in Medicinal Chemistry Translational Pharmacology in Aging Men with Benign Prostatic Hyperplasia: Molecular and Clinical Approaches to Alpha1-Adrenoceptors
Current Aging Science Caring for HIV-Infected Patients in the ICU in The Highly Active Antiretroviral Therapy Era
Current HIV Research Melatonin and Aromatase in Breast Cancer
Clinical Cancer Drugs Recent Trends in the Design, Synthesis and Biological Exploration of β-Lactams
Current Medicinal Chemistry Bronchial Asthma and Lung Cancer
Current Respiratory Medicine Reviews The Role of DNA-Microarray in Translational Cancer Research
Current Pharmacogenomics Yeast-Derived β-Glucan in Combination with Anti-Tumor Monoclonal Antibody Therapy in Cancer
Recent Patents on Anti-Cancer Drug Discovery