II. Indications (Part of combination protocols)
- FDA approved
- Stage 3 Colon Cancer
- Colorectal Cancer
- Off-Label Use - Adults
III. Mechanism
- Second-generation platinum based antineoplastic agent
- More stable and less toxic than its parent drug Cisplatin
- Components
- Platinum atom
- 1,2-diaminocyclohexane (DACH)
- Decreases Alkylating Agent resistance
- Oxalate Ligand (displaced, "leaving group")
- Activated (on displacement of the oxalate leaving group) as reactive platinum complexes
- Binds DNA (e.g. GC rich regions)
- Results in DNA cross-links
- Results in cell growth inhibition, apoptosis and cell death
IV. Dosing
- See other references for disease specific dosing protocols
V. Adverse Effects
-
Anaphylaxis
- May occur within minutes of infusion
- Acute Laryngospasm may also occur
- Bronchiolitis Obliterans Organizing Pneumonia (rare)
- Cardiovascular Toxicity
- Impaired future fertility
- Myelosuppression (Bone Marrow suppression)
-
Neuropathy
- Exposure to cold after infusion may worsen acute neurotoxicity
- Neutropenia (severe)
- Posterior Reversible Encephalopathy Syndrome (Rare)
- Pulmonary Fibrosis
- Rhabdomyolysis
- Transient Vision Loss
VI. Safety
- Avoid in Lactation
- Pregnancy Category D
- Avoid in Pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
VII. Efficacy
- More effective than Cisplatin in advanced Colorectal Cancer
VIII. Resources
- Oxaliplatin (DailyMed)
- Oxaliplatin (StatPearls)