Temozolomide (Temodal) is as effective as dacarbazine for metastatic melanoma and has the advantage of being an oral preparation, say Dr Mark Middleton (department of medical oncology, Christie hospital NHS trust, Manchester) and colleagues.
In a phase III trial involving 305 patients with advanced metastatic melanoma, temozolomide was compared with dacarbazine. Patients were given either oral temozolomide at a starting dose of 200mg/m2/day for five days every 28 days or dacarbazine 250mg/m2/day for five days every 21 days. The authors report that median survival was 7.7 and 6.4 months for temozolomide and dacarbazine, respectively, and median progression-free survival was 1.9 and 1.5 months. No major difference was seen in terms of toxicity. Dr Middleton says: "Temodal wins hands down over dacarbazine because it can be given to patients in capsule form, which they can take home instead of having to go to hospital for a very lengthy injection."
Temozolomide is licensed in the UK for treatment of two types of brain tumour. It was developed by a team of pharmacists (PJ 1999;262:467). The new trial results are reported in the Journal of Clinical Oncology (2000;18:158).