Cisplatin (cis-diamminedichloroplatinum [II]) is an inorganic metal complex that was initially

discovered through a serendipitous observation that neutral platinum complexes inhibited

division and induced filamentous growth of Escherichia coli. mechanism of action of the
platinum analogs is unclear, they are thought to exert their cytotoxic effects in the same manner
as alkylating agents. they kill tumor cells in all stages of the cell cycle and bind DNA through
the formation of intrastrand and interstrand cross-links, thereby leading to inhibition of DNA
synthesis and function. The primary binding site is the N7 position of guanine. bind to both
cytoplasmic and nuclear proteins, which may also contribute to their cytotoxic and antitumor
effects. The platinum complexes appear to synergize with certain other anticancer drugs,
including alkylating agents, fluoropyrimidines, and taxanes.

cisplatin and the other platinum analogs are extensively cleared by the kidneys and excreted in
the urine. As a result, dose modification is required in the setting of renal dysfunction.

100 mg/m2 on days 1, 22, and 43

Half life: 30minutes

Renal impairment :

Cr cl 10-50ml/min decrease dose by 50%

<10 contraindicated

Cbc & audiometric testing before each dose

Pretreatment hydration: 1-2l fluid infused for 8-12 before dose

Cisplatin Forms Non-small cell and small Nausea and Nephrotoxicity,
intrastrand and cell lung cancer, breast vomiting peripheral sensory
interstrand DNA cancer, bladder cancer, neuropathy, ototoxicity,
cross-links; gastroesophageal nerve dysfunction,
binding to cancer, head and neck alopecia, seizures,
nuclear and cancer, ovarian cancer, electrolyte imbalane,
cytoplasmic germ cell cancer anaphylaxis
proteins

Carboplatin Same as Non-small cell and small Nausea and Myelosuppression;

cisplatin cell lung cancer, breast vomiting rarely: peripheral
cancer, bladder cancer, neuropathy, renal
head and neck cancer, toxicity, hepatic
ovarian cancer dysfunction

Oxaliplatin Same as Colorectal cancer, Nausea and Myelosuppression,

cisplatin gastroesophageal vomiting, peripheral sensory
cancer, pancreatic laryngopharyngeal neuropathy, diarrhea
cancer dysesthesias