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Summary
June 2007, Vol. 3, No. 3, Pages 263-271
(doi:10.2217/14796694.3.3.263)
Oblimersen in the treatment of metastatic melanoma Ahmad A Tarhini * & John M Kirkwood *Assisstant Professor of Medicine University of Pittsburgh School of Medicine, Melanoma & Skin Cancer Program, UPCI UPMC Cancer Pavilion, 5150 Centre Avenue, Pittsburgh, PA 15232, USA. *Both authors contributed equally. tarhiniaa@upmc.edu Professor and Vice Chairman, Director, Melanoma and Skin Cancer Program University of Pittsburgh School of Medicine, Department of Medicine, Melanoma and Skin Cancer Program, UPCI Hillman Cancer Center, 5117 Centre Avenue, Pittsburgh, PA 15213, USA. *Both authors contributed equally. kirkwoodjm@upmc.edu † Author for correspondence Oblimersen (Genasense®) is a Bcl-2 antisense compound that selectively targets Bcl-2 RNA for degradation by RNase H and thereby decreases Bcl-2 protein production. Bcl-2 protein plays a major role in preventing apoptosis and has been linked to chemotherapy resistance in melanoma. Preclinical studies with oblimersen in melanoma cell lines and xenograft models of melanoma have demonstrated downregulation of Bcl-2 protein, induction of apoptosis and enhanced tumor response when combined with chemotherapy. Results of a Phase I/II study have shown that reducing Bcl-2 with oblimersen coincident with the administration of dacarbazine may amplify apoptosis and improve therapeutic outcome. A subsequent Phase III trial showed that the addition of oblimersen to dacarbazine significantly improved multiple clinical outcomes relative to dacarbazine alone based on an intent-to-treat analysis of progression-free survival and response rate (overall, complete and durable), as well as overall survival in patients with normal lactate dehydrogenase. This article reviews the biochemistry, pharmacodynamics and pharmacokinetics, safety and efficacy data related to oblimersen in melanoma.
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