P37 Weekly bevacizumab and paclitaxel in patients with metastatic melanoma:

Introduction-Aim Metastatic melanoma remains a disease with poor prognosis, with 5-year survival rates not exceeding 10%. Responses in most chemotherapeutic agents are limited. Angiogenesis is one of the most interesting therapeutic targets. The aim of this study is to evaluate the efficacy and tolerance of the combination of paclitaxel and the antioangiogenic agent bevacizumab given on a weekly schedule as anyline treatment for patients with metastatic melanoma. Patients and methods Patients with metastatic melanoma, received the combination of Bevacizumab 5 mg/kg and Paclitaxel 60 mg/m2, on a weekly schedule and on an outpatient basis. Results From October 2009, a total of 7 patients have received the above regimen until today, 5 men aged 34–70 (median 55) years and 2 women aged 40–73 (median 56.5) years, of median ECOG PS 1. The primary site was acral melanoma (3), trunk melanoma (1), melanoma of unknown primary (1) and ocular melanoma (1). All patients have received prior combination chemotherapy, such as Dacarbazine-Vindesine (1), Cisplatin-Vinblastine-Temozolomide (4), Fotemustine (1), Docetaxel-Carboplatin (1). Disease extent at study entry included visceral and subcutaneous metastases in all cases (lung in 3, liver in 3, large bowel in 1, abdominal disease in 1, breast nodules in 1). So far, 3 out of 7 patients are evaluable for response, all three achieved an objective response; two partial responses (two following 2 cycles, one at the end of 6 cycles) with response duration of 2, 3, 3+ months. The remaining 3 patients are still ongoing and are not evaluable for response yet. The toxicity observed was acceptable, with one case of grade II neutropenia requiring GCSF support, two with anaemia grade II, two with mild neurotoxicity (grade I) and alopecia grade I. There were no toxicity-related delays or discontinuations and no treatment-related deaths. All patients are alive. Conclusion The combination of bevacizumab and paclitaxel administered on a weekly basis shows, so far, promising efficacy and excellent tolerance in a pretreated patient population with metastatic melanoma. Exploiting the antiangiogenic effects of this regimen might have therapeutic benefits worth further evaluation.