Temozolomide a good option for late adjuvant therapy in melanoma patients

Use of a single-agent temozolomide appears to be an effective alternative to late adjuvant therapy in patients with melanoma if novel treatments, such as targeting and immune therapies, are not available, suggests a recent study.

Twenty-seven adults with cutaneous melanoma (median age, 55 years; 74 percent male) whose relapses were completely resected participated in this study. The investigators used a standard agent for metastatic melanoma in late adjuvant chemotherapy for cutaneous melanoma to evaluate the efficacy of single-agent temozolomide.

Temozolomide 200 mg/m² was administered perorally once daily for 5 consecutive days of a 28-day treatment cycle for six cycles. Median follow-up time was 23.6 months (range, 3.6–122.6 months).

Of the patients, 14 (51.9 percent) had any type of relapse, and five relapsed while on chemotherapy. Nearly all relapses (n=13; 93 percent) occurred within the first 2 years of follow-up, with rates of 37.4 percent and 49.1 percent in the first and second year, respectively. The relapse rate after the fifth year of chemotherapy onset stood at 51.9 percent.

The median relapse-free survival (RFS) was 12.9 months. The RFS rates a 1, 2, 3, and 5 years were 60 percent, 46 percent, 39 percent, and 39 percent, respectively.

Furthermore, the estimated median overall survival was 23.6 months. All patients survived after 1 year (n=27; 100 percent). The overall survival rates for 2, 3, and 5 years were 81 percent, 48 percent, and 48 percent, respectively.