**7.2 Chemotherapy**

There is no standard chemotherapy regimen for AM due to the rarity of the disease. However, dacarbazine in combination with high-dose interferon and interleukin-2 was found to be effective in 10–20% cases of mucosal melanomas [54]. In a Turkish study of 6 AM patients, all patients received APR followed by adjuvant chemo- and radiotherapy [55]. The adjuvant chemotherapy included dacarbazine and temozolomide. In addition, two patients received ipilimumab, and one patient received interferon therapy. At the mean postoperative follow up of 12.5 months (6–26 months), 4 patients died due to extensive distant metastases while two patients were disease free [55]. In another study of 22 patients with metastatic AM, six patients received dacarbazine while one patient received temozolomide and thalidomide. The median survival in these patients was 9 months [56].
