Platinol is the brand name for a widely-used chemotherapy drug called cisplatin. It was first approved for use in treating cancer by the U.S. Food and Drug Administration (FDA) in 1978. Currently manufactured by Bristol-Myers Squibb, Teva Pharmaceuticals, Tocris Biosciences, and many other pharmaceuticals, cisplatin is widely available in both brand name and generic form.
Like other chemotherapy drugs, cisplatin is delivered as an intravenous injection and is administered in cycles. It belongs to the platinum-based class of chemotherapy drugs that seek out and kill fast-growing cells in the body. Cisplatin is a common choice for treating mesothelioma, but it is often used in combination with other drugs. It can cause serious side effects that must be monitored carefully.
What Is Cisplatin?
Cisplatin is a platinum-containing compound and chemotherapy drug that fights cancer by specifically attacking fast-growing cells in the body. It is administered intravenously for several hours, but only once every three to four weeks. Because cisplatin is only specific to fast-growing cells, it kills cancer cells and healthy cells that also grow and divide rapidly. This is what causes certain side effects in patients. Patients are typically given as much of the drug as they can handle, in terms of side effects. It is thought that cisplatin causes cancer cells to die by binding to and distorting the DNA, which triggers induced cell death.
Cisplatin is used to treat several types of cancers, including head and neck cancers, bladder cancer, breast cancer, testicular cancer, ovarian cancer, cervical cancer, lung cancer, brain cancer, and mesothelioma. When it first came on the market in 1978, cisplatin was found to be able to cure testicular cancer, a big advancement in cancer research and treatment. Its discovery was accidental, but since it was approved it has saved lives and continues to be an important part of cancer research and clinical trials.
Combination Therapy with Cisplatin
Cisplatin combined with other chemotherapy drugs has been the basic approach to treating a number of cancers for decades. The reason for combining it with other drugs is that even when cisplatin is effective used alone, it is only effective for a limited period of time. Eventually, often after a relapse of the cancer, the cancer cells in the body become immune to the drug.
To combat this resistance, cisplatin is usually combined with one or two other chemotherapy drugs. Combinations are also popular for treating mesothelioma patients because cisplatin alone only has a small response rate on mesothelioma tumors. For mesothelioma, doxorubicin is a common choice for cisplatin combination therapy. Other possible combinations for cisplatin and treating mesothelioma include Alimta and gemcitabine.
Cisplatin in Mesothelioma Treatment
Cisplatin, most often in combination with other chemotherapy drugs, can be used in a couple of ways to treat mesothelioma patients. It may be used after surgery to try to eliminate any remaining cancer cells that the surgeon could not see or physically remove. In patients who are not good candidates for surgery, cisplatin and other drugs are usually used to slow the progression of the disease.
Combined with doxorubicin, cisplatin is often used in mesothelioma patients in the advanced stages needing palliative care. The combination helps relieve symptoms of the cancer to make patients more comfortable. More recently, cisplatin has been combined with Alimta for mesothelioma patients with positive results. Clinical trials have shown that patients with mesothelioma live longer when given this combination than when receiving cisplatin alone.
Cisplatin has also been tested in combination with the chemotherapy drug gemcitabine for mesothelioma patients. The results of a clinical trial in Australia demonstrated that about half of patients responded well to the combination and that the survival time of patients could be extended by an average of ten months. A combination of radical surgery, radiation, and chemotherapy with cisplatin, doxorubicin and cyclophosphamide was found in a trial to significantly improve survival times for patients.
Common Side Effects
Because cisplatin kills rapidly-growing cells indiscriminately, it causes a number of common side effects in most patients. These more common and less severe side effects will mostly subside once the chemotherapy treatment is finished. These include nausea, vomiting, hair loss, diarrhea, changes in taste, low red and white blood cell counts, hearing loss, and numbness and tingling in the fingers and toes.
These side effects can be managed to some extent. For instance, doctors may recommend that a patient take a course of vitamin B12 supplements to help avoid anemia and fatigue. Many patients are also given anti-nausea drugs while on a course of cisplatin. Alternative therapies like acupuncture, massage, and good nutrition, may also help patients cope with and find some relief from the side effects of cisplatin.
Serious Side Effects
Cisplatin also has the potential to cause very serious side effects. Any signs of these should be reported to a doctor immediately. Platinol and cisplatin carry a black box warning, the FDA’s most severe warning label, to make sure patients and doctors understand some of the most serious potential risks of using this medication.
One big concern is kidney toxicity. As a heavy metal, the platinum in cisplatin can cause serious toxicity issues in some patient, especially in those who have already had kidney problems. Patients on cisplatin who experience severe fatigue, decreased urination, or swelling in the legs, arms, feet, hands, or face, should report the signs right away. Hearing loss is another potentially serious problem. Especially in children on cisplatin, the drug can cause permanent hearing loss.
Other serious signs to watch out for include signs of infection, such as chills and a fever, blood in the stool, bloody vomit, seizures, vision loss or eye pain, muscle cramps, and chest pains. Some people may have a severe reaction to cisplatin, which may include a rash or irritation at the injection site, swelling in the face and mouth, difficulty breathing, hives, and dizziness. For some patients the side effects and risks of complications with cisplatin are too severe and its use has to be discontinued. These patients may benefit from an alternative, like carboplatin, or a chemotherapy drug that does not contain platinum at all.
For many mesothelioma patients, cisplatin and Platinol play an important role in treatment and management of the disease. While the side effects can be uncomfortable or even severe enough to prohibit treatment, many people tolerate it well. With mesothelioma, treatment with cisplatin and other chemotherapy drugs may be the only treatment option because surgery if often impossible in the later stages when the cancer has spread. With more research ongoing into combinations of cisplatin with other drugs, more patients will likely be able to benefit from the positive effects of cisplatin.
Page Edited by Dave Foster
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