Carboplatin, paclitaxel, bevacizumab combination promising for stage IV melanoma.. Jim breitfeller

Carboplatin, paclitaxel, bevacizumab combination promising for stage IV melanoma

Martha Kerr
Last Updated: 2009-02-06 15:25:51 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Triple therapy with monthly carboplatin, weekly paclitaxel and biweekly bevacizumab for patients with unresectable stage IV melanoma achieved "the best result ever in a clinical trial of metastatic melanoma conducted at the Mayo Clinic," investigators report.

Dr. Svetomir Markovic and colleagues in Rochester, Minnesota, conducted a two-stage phase II study of the triple chemotherapy regimen in 53 patients with unresectable stage IV melanoma. Carboplatin was given on day 1 of a 28-day cycle. Paclitaxel was given on days 1, 8 and 15. Bevacizumab was given on days 1 and 15. Treatment was continued until patients achieved remission or experienced intolerable toxicity.

The Mayo Clinic team reports in the January 1 issue of Cancer that nine patients (17%) achieved partial remission. Thirty patients (57%) achieved stable disease for at least 8 weeks.

Median progression-free survival was 6 months and median overall survival was 12 months. One patient died after eight treatment cycles from intracranial hemorrhage at the site of undiagnosed brain metastases.

Severe grade 3 or higher toxicities that limited treatment included neutropenia in 53%, thrombocytopenia in 11%, hypertension in 9% and anemia in 8%. Bevacizumab appeared to cause the most treatment-limiting toxicity, the researchers found.

"Based on our limited phase II data, the combination seems effective," Dr. Markovic said.

"An ongoing randomized Genentech-sponsored phase II study of Taxol/carboplatin compared with Taxol/carboplatin/bevacizumab in stage IV melanoma is under way," Dr. Markovic added. "If there is an advantage to the bevacizumab arm, as we would suspect, we would proceed with a randomized phase III clinical trial comparing the new combination with 'standard of care.'"

"The phase III study is already written and we will implement its final development upon release of the data from the randomized phase II study," Dr. Markovic concluded.

Cancer 2009;115:119-127.

Sourc:http://www.oncolink.org/resources/article.cfm?c=3&s=8&ss=23&id=15988&month=02&year=2009


Carboplatin, paclitaxel, bevacizumab combination promising for stage IV melanoma


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