melphalan + dactinomycin

A combination of melphalan and dactinomycin (actinomycin D) used primarily in regional perfusion or isolated limb infusion (ILI) techniques for treating locally recurrent and locoregional solid malignancies, particularly melanoma and soft-tissue sarcoma of the extremities. This minimally invasive technique delivers regional chemotherapy directly to the affected limb through angiographic catheters positioned above the knee or elbow, with a tourniquet to isolate circulation. The procedure involves general anesthesia, inflation of a proximal tourniquet, and circulation of a normothermic, low-flow, hypoxic infusion of the drugs through the involved limb for about 20 minutes. The combination works through complementary cytotoxic mechanisms: melphalan as an alkylating agent disrupts DNA and RNA synthesis, while dactinomycin binds to DNA and inhibits RNA synthesis, particularly affecting transcription. Clinical trials have shown significant response rates in patients with recurrent melanoma or unresectable soft-tissue sarcoma of the limb.

Brand names

HEPZATO KIT

Other names

melphalan and dactinomycinmelphalan and actinomycin D