Fotemustine
Fotemustine is a nitrosourea alkylating agent used in the treatment of metastatic melanoma. It is available in Europe but has not been approved by the United States FDA. A study has shown that fotemustine produces improved response rates and but does not increase survival. There was also toxicity prevalence in fotemustine arm. The main toxicity was grade 3 to 4 neutropenia and thrombocytopenia.