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Japanese Journal of Clinical Oncology Advance Access originally published online on August 24, 2005
Japanese Journal of Clinical Oncology 2005 35(9):507-513; doi:10.1093/jjco/hyi141
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© 2005 Foundation for Promotion of Cancer Research

Complete Remission of Brain Metastases in Three Patients with Stage IV Melanoma Treated with BOLD and G-CSF

Ugo Bottoni1, Paola Bonaccorsi2, Valeria Devirgiliis2, Vincenzo Panasiti2, Riccardo Giovanni Borroni2, Guido Trasimeni3, Rita Clerico2 and Stefano Calvieri2

1 Department of Dermatology, University of Catanzaro, Magna Graecia, 2 Department of Dermatology, University of Rome, La Sapienza and 3 Department of Radiology, General Medicine I, University of Rome, La Sapienza, Italy

For reprints and all correspondence: Ugo Bottoni, Department of Dermatology, University of Catanzaro, Magna Graecia, Via Sinopoli, 9, 88100 Catanzaro, Italy. E-mail: ugobottoni{at}unicz.it

Received April 13, 2005; accepted June 19, 2005

Background: Brain metastases are the most life-threatening among the secondary localizations of melanoma for their unresponsiveness to the surgical, radiotherapeutic and/or chemotherapeutic treatments.

Methods: Accidentally, we observed a complete response (CR) in a patient undergoing chemotherapy with bleomycin, vincristine or Oncovin, CCNU or lomustine, dacarbazine (BOLD) regimen for metastatic melanoma including brain metastases, who was also treated with G-CSF to manage a concomitant leukopenia. After this observation, seven more patients with stage IV melanoma with brain metastases were treated with BOLD regimen repeated every 6 weeks with administration of G-CSF in the intervals.

Results: Three patients presented CR (37.5%). Two patients stopped the treatment after two courses for evident progressive disease (25%). The other three patients showed stable disease (SD: 37.5%). Median duration of SD was 24 weeks. Among the eight patients, six (75%) achieved clinical benefit. Median time to progression was 8.5 months (range 0–74+ months). Median survival was 12.5 months (range 4–74+ months). Two patients are still alive and disease-free after 74 and 57 months, respectively.

Conclusion: We believe that the brilliant CR, the long duration of the disease-free intervals and the long survival in at least three of eight patients should encourage further research on BOLD with G-CSF for the treatment of advanced melanoma.

Key Words: brain metastases • melanoma • polychemotherapy • G-CSF • BOLD


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