Genetic Variates of Response to Cisplatin, Vinblastine, and Temozolomide (CVT) in Patients With Metastatic Melanoma

Inclusion criteria

• Age ≥ 18 years
• Histologic proof of melanoma reviewed and confirmed at MSKCC
• Patients must have stage IV melanoma or recurrent stage IIIb or IIIc melanoma. Patients who are potentially respectable will be eligible.
• Measurable disease (RECIST criteria). Patients must have a tumor amenable to biopsy for oligonucleotide microarray analysis and for immunohistochemistry. A pre-treatment biopsy is required; a fine needle aspirate is not adequate.
• No prior cytotoxic chemotherapy for melanoma. Prior immunotherapy or anti-angiogenic therapy is allowed.
• No other concurrent chemotherapy, immunotherapy, or radiotherapy
• ECOG performance status ≤ 1
• Adequate organ function defined as follows: ANC >1500/mm3, Platelets >130,000/mm3, calculated creatinine clearance ≥60 ml/minute (Cockcroft & Gault).
• Adequate cardiac function to tolerate the hydration needed for cisplatin administration.

Exclusion criteria

• History of CNS metastases unless brain metastases have been resected or successfully treated with stereotactic radiosurgery and the patient has been free from CNS recurrence for 3 months.
• Uveal melanoma primary
• Patients who have had prior anti-CTLA4 monoclonal antibody treatment must have been off treatment for at least 4 months and have signs of progression of disease.
• Frequent vomiting or medical conditions that could interfere with oral medication intake
• Serious infection requiring antibiotics, or nonmalignant medical illnesses that are uncontrolled or whose control might be jeopardized by the complications of this therapy.
• History of HIV infection even if on HAART
• Immunosuppressive drugs
• High dose vitamins and herbs
• Other on-going investigational therapy, concurrent chemotherapy, immunotherapy or radiotherapy.