Clinical evaluation of in vitro chemosensitivity testing: the example of uveal melanoma

Purpose Results from in vitro chemosensitivity testing recommend treosulfan/gemcitabine chemotherapy for the treatment of stage IV uveal melanoma.Methods Twenty patients received treosulfan 3,500 mg/m² followed by gemcitabine 1,000 mg/m² on day 1 and day 8 repeated on day 29. In cases of prior chemotherapy only 75% of these dosages were used.Results Without any patient achieving an objective response, 25% of patients (95% confidence interval, 8.6–49.1%) had stabilisation of disease. This stabilisation was associated with a prolonged median overall survival of 17 months compared with 7 months for the patients with progressive disease. First-line treatment was not associated with better response or survival although prognostic parameters did not significantly differ from that of other patients.Conclusions The results are disappointing and question the value of individualized chemotherapy based on in vitro assays.