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J Dermatolog Treat. 2014 Oct;25(5):396-400. doi: 10.3109/09546634.2012.697986. Epub 2012 Sep 2.

Metastatic melanoma: results of 'classical' second-line treatment with cytotoxic chemotherapies.

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Department of Medical Oncology, Centre Régional de Lutte Contre le Cancer Eugène Marquis , Rennes , France.



Metastatic melanoma is one of the most aggressive tumours, with a median survival that does not exceed 12 months. None of the cytotoxic first-line therapies have shown survival benefit in randomised clinical trials.


To describe clinical benefit of second-line cytotoxic chemotherapy in the second line of treatment for metastatic melanoma.


In a retrospective study, we analyse the outcome of patients with metastatic melanoma who had received two lines or more of cytotoxic treatments in four French dermato-oncology departments between 1999 and 2009.


We describe the outcomes for 109 patients. Most of these patients received dacarbazine for the first line of chemotherapy and fotemustine for the second line of chemotherapy (67.0 and 64.2%, respectively). A clinical benefit was observed in 24.1% of the patients and overall survival was 4.1 months after the second-line treatment. At least 23.8% of patients suffered from grade 3 or 4 toxicities. The presence of more than two sites of metastasis and an M1c staging according to the AJCC classification represented negative predictive factors of clinical benefit.


This study shows the modest benefit of a second line of cytotoxic chemotherapy in a nonselected population. If eligible, these patients should be proposed for ongoing clinical trials or for targeted therapies.

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