Cisplatin + Vinblastine + Temozolomide

## Basic Information The combination consists of three distinct chemotherapeutic agents: 1. **Cisplatin** - A platinum-based alkylating agent that forms DNA crosslinks 2. **Vinblastine** - A vinca alkaloid that inhibits microtubule assembly 3. **Temozolomide** - An alkylating agent that damages DNA through methylation ## Dosing Regimen The typical dosing schedule for this combination includes: - Cisplatin: 20-30 mg/m² intravenously on days 1-3 or 1-4 - Vinblastine: 1.5-2 mg/m² intravenously on days 1-3 or 1-4 - Temozolomide: 125-150 mg/m² orally on days 1-5 The regimen is typically administered in cycles every 21-28 days, with pegfilgrastim support often provided to manage potential hematological toxicities. ## Clinical Applications This combination has been used primarily in: - Relapsed refractory melanoma (RRM), especially in patients ineligible for clinical trials - Metastatic melanoma, including patients with brain metastases - As a first-line treatment option for advanced melanoma, particularly in the pre-immune checkpoint inhibitor era ## Efficacy Clinical studies have shown: - Overall response rates (ORR) ranging from approximately 17.8% to 34% - Clinical benefit rates (CBR) of up to 60% - Median progression-free survival of approximately 4 months - Median overall survival of 10-12 months ## Toxicity Profile The main adverse effects reported include: - Hematological toxicities (grades 3-4): neutropenia (1.8%), thrombocytopenia (1.8%), and anemia (1.2%) - Dose modifications are sometimes required (40% for temozolomide, 13.3% for cisplatin) - Generally considered well-tolerated with manageable toxicity ## Biomarkers Some studies have investigated potential predictive biomarkers for response to this regimen: - BRAF mutation status - MGMT (O6-methylguanine-DNA methyltransferase) expression - ERCC1 (excision repair cross-complementation group 1 enzyme) expression Interestingly, patients with BRAF-mutated tumors and low MGMT nuclear expression may have better progression-free survival with this regimen.

Other names

CVT regimen