Fotemustine is a nitrosoureaalkylating agent used in the treatment of metastaticmelanoma. It is available in Europe but has not been approved by the United States FDA.[1] A study[2] has shown that fotemustine produces improved response rates and but does not increase survival (over dacarbazine in the treatment of disseminated cutaneous melanoma. Median survival was 7.3 months with fotemustine versus 5.6 months with DTIC (P=.067). There was also toxicity prevalence in fotemustine arm. The main toxicity was grade 3 to 4 neutropenia (51% with fotemustine v 5% with DTIC) and thrombocytopenia (43% v 6%, respectively).
^Avril MF, Aamdal S, Grob JJ, Hauschild A, Mohr P, Bonerandi JJ, Weichenthal M (March 2004). "Fotemustine Compared With Dacarbazine in Patients With Disseminated Malignant Melanoma: A Phase III Study". Journal of Clinical Oncology. 22 (6): 1118–25. doi:10.1200/JCO.2004.04.165. PMID15020614.