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- W2022053633 abstract "Surgery is the treatment of choice for all accessible primary malignant melanomas (MM), 1 at least partly because of the poor response rate to other therapeutic measures. Excisional therapy is often impossible for extensive primary, recurrent, or metastatic lesions, and in such patients alternate treatment regimens must be employed. The surgical management of MM was reviewed in an earlier article appearing in this section of the Joumar'; this month's issue highlights the chemotherapy of this aggressive cutaneous neoplasm. Effective chemotherapy for MM remains more of a dream than a reality; a consistently effective drug regimen has yet to be developed for any stage of the disorder. This relative treatment resistance may be at least partially explained by the growth kinetics of the tumor; only a small proportion of cells is actively dividing at any one time, making toxicity a serious problem at therapeutic drug levels. Nitrosourea compounds, including carmustine (BCNU) and lomustine (CCNU), alone or in combination with dacarbazine (DTIC-Dome), have been used with limited success,a'4 as have the vinca alkaloids, vincristine and vinblastine, 4'~ and the alkylating agent cyclophosphamide, t~ Methotrexate, a powerful antitumor agent which disrupts cellular DNA synthesis by inhibiting the enzyme dihydrofolate reductase, is conspicuously ineffective against MM. 7 Kufe et al 8 studied the natural resistance of human MM to methotrexate. The ability of nonmelanoma tumor cells to develop resistance to this drug has been described previously ~ and appears to correlate with increased intracellular levels of dihydrofolate reductase and/" @default.
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- W2022053633 date "1982-03-01" @default.
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- W2022053633 title "Chemotherapy of malignant melanoma" @default.
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- W2022053633 doi "https://doi.org/10.1016/s0190-9622(82)80292-2" @default.
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