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Cancer Chemotherapy for Melanoma: Dacarbazine

A Patient's Guide to Cancer Chemotherapy with Dacarbazine

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Updated May 05, 2009

Dacarbazine

Dacarbazine is the only FDA-approved chemotherapy drug for metastatic melanoma

photo © A.D.A.M.

Cancer chemotherapy has long been a mainstay for treating metastatic melanoma (that is, melanoma that has spread beyond its site of origin). Unfortunately, there isn't a clear consensus among doctors about the most effective use of these drugs, which most likely reflects their low level of activity. Their side effects, however, are well-known and should be understood completely before treatment. This overview is part of a series that will introduce you to the most common chemotherapy drugs used to treat metastatic melanoma.

Note that this information may not cover all possible precautions, interactions or adverse effects for these drugs. If you have any questions about the drugs you are taking, be sure to talk about dacarbazine with your healthcare professional.

Other Names (United States)

DTIC-Dome

Approved

1975

Description

Dacarbazine is an "alkylating agent" that links together specific sections of DNA, which then prevents cell division and results in cell death. It is similar to the chemotherapy drug temozolimide.

Usage of Dacarbazine

Injection into a vein

Evidence that Dacarbazine is Effective

Dacarbazine is currently the only FDA-approved chemotherapy drug for metastatic stage IV melanoma. While it is the best available treatment and the standard against which new melanoma drugs are evaluated, it is unfortunately not very effective: a recent review of the research showed an average response rate of only 15.3% with no significant improvement in overall survival. Almost all responses were partial, with a median response duration of only 7 to 8 months. Dacarbazine has also been studied in combination with other drugs, as in the CVD (cisplatin, vincristine and dacarbazine) and BVLD (bleomycin, vincristine, lomustine and dacarbazine) combination regimens. The evidence so far, however, does not show an advantage over the use of dacarbazine alone.

Researcher Philip Lui, PharmD of Toronto General Hospital, concludes, “Dacarbazine generally produces poor outcomes. Adding other therapies offers minimal clinical advantages. In general, [the quality of dacarbazine studies] is poor and sample sizes are small. This . . . highlights the unmet need for effective treatment options for advanced melanoma.”

Potential Side Effects

Dacarbazine can cause a significant decrease in the number of blood cells in your bone marrow. It can also cause severe liver damage, and it has been associated with the development of other types of cancer.

The following serious side effects have occurred in a small percentage of people taking dacarbazine. If you experience any of these, seek emergency medical attention immediately:

  • skin rash; itching or hives; pain at the injection site; and swelling of the face, lips or tongue (signs of an allergic reaction)
  • fever or chills, cough, sore throat, pain or difficulty passing urine (signs of infection due to a decrease in the number of white blood cells)
  • bruising; pinpoint red spots on the skin; black, tarry stools; and blood in the urine (signs of a decreased number of platelets)
  • severe weakness, fainting spells and lightheadedness (signs of a decreased number red blood cells)

The following less serious side effects have also been reported but don’t require immediate attention:

  • loss of appetite
  • fatigue
  • muscle pain
  • loss of hair
  • nausea and vomiting

Interactions and Cautions

Do not take dacarbazine if you have had an allergic reaction (a “hypersensitivity reaction”) to it in the past. Tell your doctor if you take medicines to increase blood counts, such as filgrastim, pegfilgrastim and sargramostim.

Sources:

Melanoma. National Comprehensive Cancer Network. V1.2009. 23 November 2008.

Dacarbazine. Drug Information Portal. US National Library of Medicine. 25 November 2008.

Lui P, et al. “Treatments for metastatic melanoma: synthesis of evidence from randomized trials.” Cancer Treat Rev 2007 33(8), 665-80. 30 November 2008.

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