Dacarbazine is commonly used as a treatment for metastatic

melanoma and has been for long time the standard of care for this disease. Recently, new approaches have completely changed the diagnosis and treatment of melanoma. New medications like vemurafenib have been developed for the systemic therapy of advanced melanomas in subpopulations selleck inhibitor identified by BRAF mutation tests. Inhibitors,research,lifescience,medical Taxanes have been reported to have some limited activity in malignant melanoma [54–58], due to the high toxicity attributed to their waterinsolubility. In a phase II clinical trial Hersh at al. in 2010 [46] demonstrated that nab-paclitaxel has activity not only in chemotherapy-naïve patients with metastatic melanoma administered at a dose of 150mg/m2 but also in previously treated patients administered at a dose of 100mg/m2 for 3 of 4 weeks. In this study, PFS and OS were longer than the previous results Inhibitors,research,lifescience,medical reported with conventional standard of care. In previously treated and chemotherapy-naïve patients, PFS was 4.5 months and 3.5 months, respectively, and similarly OS was 9.6 months and 12.1 months (in respect to 1.6 months of PFS reported in the literature for treatment with dacarbazine and temozolomide). Inhibitors,research,lifescience,medical In another phase II clinical trial, Kottschade et al. in 2011 [59] demonstrated that in patients with metastatic melanoma the combination of nab-paclitaxel 100mg/m2 and carboplatin AUC2 administered in days 1, 8, and 15 every 28 days

is moderately tolerated for the occurrence of adverse effects that were fatigue, myelodepression,

and gastrointestinal toxicity. This study confirms that the efficacy and toxicity of nab-paclitaxel are similar to those of paclitaxel when combined with carboplatin for the treatment Inhibitors,research,lifescience,medical of patients with metastatic melanoma. Even if such regimens have not been formally compared in a randomized study, we can say that nab-paclitaxel is a good alternative for patients who cannot tolerate conventional therapy with paclitaxel. Last November at the Society of Melanoma Research Inhibitors,research,lifescience,medical a preliminary analysis of a Phase III study by Hersh was presented which shows benefit in terms of PFS in favor of nab-paclitaxel compared to dacarbazine (4.8 versus 2.5 months); the same why trend was observed in the interim analysis that shows a trend for better OS (12.8 versus 10.7 months) (Table 3). Recently, nab-paclitaxel was efficiently combined with temozolomide and oblimersen in the treatment of melanoma patients. In detail, in a phase I trial, chemotherapy-naïve patients with metastatic melanoma and normal LDH levels were enrolled in 3 cohorts. The treatment regimen consisted of 56-day cycles of oblimersen (7mg/kg/day continuous i.v. infusion on days 1–7 and 22–28 in cohort 1 and 2; 900mg fixed dose, twice weekly in weeks 1-2, 4-5 for cohort 3), temozolomide (75mg/m2, days 1–42), and nab-paclitaxel (175mg/m2 in cohort 1 and 3, 260mg/m2 in cohort 2 on days 7 and 28).