A phase II study with cisplatin plus 24-hour infusion of ifosfamide (with mesna uroprotection) was performed in patients with metastatic malignant melanoma. The overall response rate was 40% (7% complete and 33% partial remission). The response rate in patients with a WHO performance score of 0 was 64%. Survival for patients in partial remission ranged from 1-12 months (median 7), which is disappointing in view of the toxicity. Side effects were substantial, with severe leucopenia in 82% and thrombocytopenia in 71%. Renal toxicity was observed in 31% and was severe in 6%. There was 1 toxic death. Although the response rate is high, toxicity precludes the standard use of this regimen until the effect of rescue agents for myelo- and renal toxicity is proven.