D.N.C.B. for malignant melanoma: significance in the treatment strategy

2-4 Dinitrochlorobenzene (D.N.C.B.) is a synthetic primary allergenic molecule which has proved to have at least two useful clinical applications as regards neoplastic conditions. As a diagnostic measure, it serves in the detection of global alterations of cellular immunity. As a therapeutical measure, its epicutaneous use has proved to stimulate immune defence reactions loco-regionally if not systemically. This second property finds an important field of application in the treatment of malignant melanoma (M.M.), the reason for this being that natural immune defence reactions seem to play an important role in the natural history of this type of tumor. This review collects literature data on the therapeutical use of D.N.C.B: which, together with personal cases, show that this type of treatment may be proposed as a palliative measure for the treatment of skin metastases or as an adjuvant measure for surgery in the treatment of M.M. with surgically accessible metastases. D.N.C.B. appears to be part of a new therapeutical group, the Biological Response Modifiers (B.R.M.), and would seem to have a place in future treatment protocols associating B.R.M. with other treatment methods (e.g. chemotherapy).     

Role of recombinant alpha-interferon in the treatment of advanced cutaneous malignant melanoma.

A total of 65 patients with advanced cutaneous malignant melanoma (MM) have now been treated with interferon alpha-2b (Intron A) at a dose of 10 million IU/m2 administered subcutaneously thrice weekly. Fifty-one patients were evaluable for response, and 4 of these (7.8%) achieved complete remission; 2 of these 4 remain so at 37 + and 54 + months. Six additional patients achieved a partial remission. All responders had subcutaneous, lymph node and/or pulmonary metastases only. In all responders, therapy was continued for a total of 12 months. The vast majority of patients experienced side effects, largely flu-like symptoms, mild leukopenia and mild hepatocellular dysfunction. No evidence of cumulative toxicity was observed. Our experience indicates that interferon alpha-2b is active in patients with advanced cutaneous MM.     

Assessment of an in vitro screening test of cytotoxic agents in the treatment of advanced malignant disease

The value of a screening test for sytoxic chemotherapeutic agents in the treatment of advanced malignant disease is assessed by comparing the performances of 32 patients whose treatment followed closely the test recommendations with that of 31 patients whose treatment did not follow the predictions. The significant improvement in short-term prognosis (p=0.004) indicates that the test is of clinical value. The limitations of retrospective analysis are discussed in detail.