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Japanese Journal of Clinical Oncology Advance Access published online on August 24, 2005
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyi141
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© 2005 Foundation for Promotion of Cancer Research
Received April 13, 2005
Accepted June 19, 2005

Original Article

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

Ugo Bottoni 1*, Paola Bonaccorsi 2, Valeria Devirgiliis 2, Vincenzo Panasiti 2, Riccardo Giovanni Borroni 3, Guido Trasimeni 4, Rita Clerico 2, and Stefano Calvieri 2

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

* To whom correspondence should be addressed.
Ugo Bottoni, E-mail: ugobottoni{at}unicz.it


  Abstract

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.

Keywords: brain metastases; melanoma; polychemotherapy; G-CSF; BOLD.
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