NCCN Guidelines for Patients® | Melanoma

45 NCCN Guidelines for Patients ® : Melanoma, 2018 4  Overview of melanoma treatments Chemotherapy For systemic therapy, the drug can be given as a pill that is swallowed. Or, it can be given as a liquid that is injected into a vein or under the skin with a needle. When given as systemic therapy, the drugs travel in the bloodstream to treat cancer throughout the body. For regional therapy, the drug is given as an injection into a limb (arm or leg) in a way that it does not reach or affect the rest of the body. This is called isolated limb infusion/perfusion. The chemotherapy drug melphalan is given this way for melanoma. Guide 6 lists the chemotherapy drugs used for melanoma. Except for melphalan, all of the chemotherapy drugs listed in the chart are used as systemic therapy. Chemotherapy is given in cycles of treatment days followed by days of rest. These cycles vary in length depending on which drugs are used. Usually, the cycles are 14, 21, or 28 days long. These cycles give the body a chance to recover before the next treatment. Thus, a regimen of 3 to 6 months has rest periods between treatments. A regimen is a treatment plan that specifies the dose, schedule, and length of treatment Side effects of chemotherapy Like targeted therapy, the side effects of chemotherapy depend on many factors. This includes the drug, the dose, and the person. In general, side effects are caused by the death of fast-growing cells, which are found in the intestines, mouth, and blood. Thus, common side effects of chemotherapy are nausea, vomiting, mouth sores, not feeling hungry, hair loss, low blood cell counts, fever, infections, and easy bruising or bleeding. Feeling very tired (fatigue) or weak is also common. Not all side effects of chemotherapy are listed here. Be sure to ask your treatment team for a complete list of common and rare side effects. If a side effect bothers you, tell your treatment team. There may be ways to help you feel better. There are also ways to prevent some side effects. Guide 6. Chemotherapy drugs for melanoma Generic name Brand name (sold as) Route given Carboplatin -- Liquid injected into a vein Cisplatin Platinol ® Liquid injected into a vein Dacarbazine -- Liquid injected into a vein Melphalan Alkerlan ® Liquid is infused into the arm or leg during a surgical procedure Nab-paclitaxel Abraxane ® Liquid injected into a vein Paclitaxel Taxol ® Liquid injected into a vein Temozolomide Temodar ® Pill that is swallowed or liquid injected into a vein Vinblastine sulfate -- Liquid injected into a vein