Phase II clinical trial evaluating docetaxel, vinorelbine and GM-CSF in stage IV melanoma.

Purpose: Metastatic melanoma patients have a poor prognosis. No chemotherapy regimen has improved overall survival. More effective treatments are needed.

Multiple joint effusions associated with high-dose imatinib therapy in a patient with chronic myelogenous leukaemia.

Imatinib mesylate is a small molecule tyrosine kinase inhibitor that has significant efficacy in the treatment of chronic myelogenous leukaemia (CML). However, it is likely that patients with CML will require prolonged and perhaps life-long therapy. In general, the side-effects of imatinib therapy have been mild to moderate, with the large majority of patients tolerating prolonged periods of therapy.

Docetaxel and vinorelbine plus GM-CSF in malignant melanoma.

Patients having locoregional or metastatic melanoma have a poor prognosis, with 50% to 100% of patients dying from the disease within 5 years. Current chemotherapy regimens offer limited benefits to these patients, and more effective and less toxic treatments are needed. We therefore piloted a study of docetaxel (Taxotere), vinorelbine (Navelbine), granulocyte-macrophage colony-stimulating factor (GM-CSF, sargramostim [Leukine]), or the DVS regimen, in patients with stage IV melanoma.

Combined topoisomerase I inhibition for the treatment of metastatic colon cancer.

The objective of this study was to define the maximally tolerated dose (MTD) and response rate of a combination of two topoisomerase I inhibitors, topotecan and irinotecan, in patients with metastatic colon cancer. Eleven patients, the majority with previously progressive disease on 5-fluorouracil-based regimens, were enrolled onto a phase I/II dose escalation trial utilizing continuous infusion topotecan for 2 weeks and weekly irinotecan x 3 with cycles repeated every 28 days. Dosages of topotecan utilized included 0.

Stevens-Johnson syndrome/toxic epidermal necrolysis in a patient receiving concurrent radiation and gemcitabine.

A patient with stage IV malignant melanoma treated with daily radiotherapy and low-dose (100 mg/m2) daily gemcitabine developed a blistering skin eruption, fever and neutropenia consistent with overlap Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). The diagnosis was confirmed by skin biopsy of an affected area. The case history is described, and the literature relating to the development of SJS/TEN in association with chemotherapy and radiotherapy administration is reviewed.