TY - CHAP M1 - Book, Section TI - Systemic Treatment for Stage IV Melanoma A1 - Sandhu, Shahneen A1 - Smalley, Keiran A1 - McArthur, Grant A2 - Morita, Shane Y. A2 - Balch, Charles M. A2 - Klimberg, V. Suzanne A2 - Pawlik, Timothy M. A2 - Posner, Mitchell C. A2 - Tanabe, Kenneth K. PY - 2018 T2 - Textbook of Complex General Surgical Oncology AB - Metastatic melanoma continues to place a substantial economic burden on western caucasian populations because of the disproportionately high incidence in young patients.1 Historically, the prognosis for patients with metastatic disease has been dismal with a median overall survival (OS) of 6 to 9 months and a 5-year survival rate of less than 10%.2 Until 2011, only dacarbazine and high-dose interleukin 2 (IL-2) were approved for the treatment of metastatic disease. Dacarbazine gained approval in 1975 for its modest response rate of 10% and median OS of 5.6 to 9.7 months.2,3 Attempts to improve on this with other cytotoxics (temozolomide or fotemustine), cisplatin-based combination chemotherapy, biochemotherapy, and concurrent use of targeted agents with dacarbazine resulted in marginally higher response rates, additional toxicity but no added survival advantage over single agent dacarbazine.3-6 High-dose IL-2 has consistently demonstrated an objective response rate (ORR) of 16% to 23% with durable complete responses seen in approximately 5% to 10% of patients.7 High-dose IL-2, however, requires skilled inpatient management, which has largely restricted clinical application to a small number of highly specialized centers. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - hemonc.mhmedical.com/content.aspx?aid=1145756161 ER -