Prospective comparison of intralesional and multipuncture BCG in recurrent intradermal melanoma

Abstract

Fifty‐nine patients with metastatic melanoma predominantly localized in the skin were randomly assigned to treatment with BCG given either intralesionally (IL‐BCG) or by multiple puncture vaccination at a nontumor bearing site in the skin (MPV‐BCG). Half the patients with IL‐BCG experienced moderate fever, chills and malaise, suggesting systemic exposure to this live organism. However, only three of these patients required systemic antituberculous chemotherapy and all responded to it. MPV‐BCG treated patients experienced significantly less systemic toxicity. Among fully evaluable patients 45% objective response rate was seen in the IL‐BCG group and a 9% response rate in the MPV‐BCG group. a significant difference. The only complete responses were seen in the IL‐BCG group. Among fully evaluable patients, median survival was 21.1 months in the IL‐BCG group and 13.3 months in the MPV‐BCG groups (NSD). No patients with pretreatment anergy to all skin tests utilized, experienced objective response to BCG. Copyright © 1979 American Cancer Society