A phase II study of 5,6-dihydro-5-azacytidine hydrochloride in disseminated malignant melanoma

Forty patients with measurable disseminated malignant melanoma and no prior chemotherapy received monthly DHAC, 5 g/m²/24 h, as a continuous infusion. Among 26 'good risk patients' (ECOG performance score 0, 1 and no prior biological therapy), we observed 3 objective regressions. Among 14 'poor-risk patients' (ECOG PS 2 or prior biological therapy), we observed no objective regressions. For all patients, median time to progression and survival were 1 month and 6.7 months, respectively. Transient pleuritic chest pain and mild nausea and vomiting were the most common complications. We were especially impressed with a complete response (CR) for 11+ months in a 43- year-old woman with extensive visceral metastases and another CR lasting > 4.7 months in a 36-year-old woman with nonvisceral metastatic disease. The absence of myelosuppression raises intriguing possibilities for combination regimens including DHAC in the management of malignant melanoma.