-transparent.png){kind=logo}
BACKGROUND Endocrine factors may affect the clinical course of malignant melanoma and the response to the treatment of this disease. The presence of estrogen receptors in melanomas has been suggested, and occasional responses to antiestrogen therapy have been reported. RESULTS We randomly assigned 117 patients with metastatic malignant melanoma to treatment with dacarbazine alone or dacarbazine in combination with tamoxifen. The overall rate of response, measured objectively, was higher (28 percent vs. 12 percent, P = 0.03) and survival was longer (median, 48 vs. 29 weeks, P = 0.02) among the patients who received dacarbazine plus tamoxifen than among those who received dacarbazine alone. Among women, both the response rate (38 percent vs. 10 percent, P = 0.04) and the median survival (69 vs. 30 weeks, P = 0.008) were better with dacarbazine plus tamoxifen than with dacarbazine alone, whereas among men the differences were smaller and not statistically significant. Among the patients given dacarbazine alone, there were no significant differences between women and men in response rate (10 percent vs. 13 percent) or survival (30 vs. 27 weeks), whereas among those given dacarbazine plus tamoxifen, women had better outcomes, as indicated by both response rate (38 percent vs. 19 percent, P = 0.15) and survival (69 vs. 31 weeks, P = 0.02). When we analyzed the Quetelet body-mass index (the weight in kilograms divided by the square of the height in meters) as an indirect indicator of the levels of endogenous estrogens in postmenopausal women and in men, survival was not affected by the body-mass index in the group given dacarbazine alone, whereas in the group given dacarbazine plus tamoxifen, survival was longer among patients whose Quetelet index was above the median value than among those with a Quetelet index lower than the median value (60 vs. 26 weeks, P less than 0.001). CONCLUSIONS In the treatment of metastatic malignant melanoma, dacarbazine plus tamoxifen is more effective than dacarbazine alone, as indicated by both the response rate and the median survival; the difference in efficacy is among women.
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
February 2003,
Melanoma research,
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
December 1998,
European journal of cancer (Oxford, England : 1990),
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
January 1996,
Cancer chemotherapy and pharmacology,
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
April 1998,
Melanoma research,
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
September 1987,
Cancer treatment reports,
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
August 1995,
Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
October 1989,
British journal of cancer,
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
January 1992,
European journal of cancer (Oxford, England : 1990),
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
September 1991,
Cancer,
G Cocconi, and
M Bella, and
F Calabresi, and
M Tonato, and
R Canaletti, and
C Boni, and
F Buzzi, and
G Ceci, and
E Corgna, and
P Costa
August 1992,
Cancer,
