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
AlphaFold in Medicinal Chemistry: Opportunities and Challenges
AlphaFold, a groundbreaking AI tool for protein structure prediction, is revolutionizing drug discovery. Its near-atomic accuracy unlocks new avenues for designing targeted drugs and performing efficient virtual screening. However, AlphaFold's static predictions lack the dynamic nature of proteins, crucial for understanding drug action. This is especially true for multi-domain proteins, ...read more
Artificial intelligence for Natural Products Discovery and Development
Our approach involves using computational methods to predict the potential therapeutic benefits of natural products by considering factors such as drug structure, targets, and interactions. We also employ multitarget analysis to understand the role of drug targets in disease pathways. We advocate for the use of artificial intelligence in predicting ...read more
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
- 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
-
The Mutator Phenotype in Cancer: Molecular Mechanisms and Targeting Strategies
Current Drug Targets Effect of Piperine, Quercetin, Polysorbate 80 on the Oral Bioavailability of Losartan in Male Wistar Rats
Pharmaceutical Nanotechnology Host Innate Immune Responses to Microbial Pathogens
Current Vascular Pharmacology Deterministic and Stochastic Model for the Role of the Immune Response Time Delay in Periodic Therapy of the Tumors
Current Computer-Aided Drug Design Bacterial Protein Toxins: Current and Potential Clinical Use
Current Medicinal Chemistry Indolo[2,3-a]quinolizidines and Derivatives: Bioactivity and Asymmetric Synthesis
Current Pharmaceutical Design Heme Oxygenase-1 in Lung Disease
Current Drug Targets Design of New Improved Curcumin Derivatives to Multi-targets of Cancer and Inflammation
Current Drug Targets Latest Results for Anti-Angiogenic Drugs in Cancer Treatment
Current Pharmaceutical Design Disruptive Nanozyme Technology for Futuristic Bio-Medical and Bio-imaging Applications
Current Nanoscience The Influence of Co-Ligands on Improving Tumor Targeting of <sup>99m</sup>Tc-HYNIC Conjugated Peptides
Mini-Reviews in Medicinal Chemistry How is Gene Transfection Able to Improve Current Chemotherapy? The Role of Combined Therapy in Cancer Treatment
Current Medicinal Chemistry Melatonin Regulates Angiogenic Factors under Hypoxia in Breast Cancer Cell Lines
Anti-Cancer Agents in Medicinal Chemistry Hypoxia and the Malignant Glioma Microenvironment: Regulation and Implications for Therapy
Current Molecular Pharmacology Heat Shock Protein 90 Inhibitors in Oncology
Current Proteomics Tetraketones, Synthesis and their Applications
Current Organic Synthesis The Combination of New Immunotherapy and Radiotherapy: A N ew Potential Treatment for Locally Advanced Non-Small Cell Lung Cancer
Current Clinical Pharmacology Jumping on the Train of Personalized Medicine: A Primer for Non- Geneticist Clinicians: Part 1. Fundamental Concepts in Molecular Genetics
Current Psychiatry Reviews Use of Fullerenes in Cosmetics
Recent Patents on Biotechnology Protective Effects of Downregulating Estrogen Receptor Alpha Expression in Cervical Cancer
Anti-Cancer Agents in Medicinal Chemistry