II. Indications (Part of combination protocols)

  1. FDA approved
    1. Metastatic Testicular Cancer
    2. Metastatic Ovarian Cancer
    3. Bladder Cancer
  2. Off-Label Use - Adults
    1. Cervical Cancer
    2. Endometrial Cancer
    3. Esophageal Cancer
    4. Gastric Cancer
    5. Head and neck cancer
    6. Lung Cancer (Non-small cell and small cell)
    7. Sarcoma
  3. Off-Label Use - Children
    1. Germ cell tumors
    2. Hepatoblastoma
    3. Medulloblastoma
    4. Neuroblastoma
    5. Osteosarcoma

III. Mechanism

  1. First-generation platinum based, alkylating Antineoplastic Agent
    1. Inorganic, water based compund
    2. Derived drugs include Carboplatin
  2. Components
    1. Platinum atom
    2. Ammonia groups (2)
  3. Activated via hydrolysis intracellularly to highly reactive, charged platinum complexes
    1. Binds DNA (e.g. GC rich regions)
    2. Results in DNA cross-links
    3. Results in cell growth inhibition (G2 Cell Cycle arrest), apoptosis and cell death
  4. Unique features
    1. Penetrates Testes barrier
    2. Partially penetrates blood brain barrier

IV. Medications

  1. Cisplatin IV Solution (1 mg/ml): 50 ml, 100 ml or 200 ml

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Alopecia
  2. Anaphylaxis
  3. Bone Marror Suppression
  4. Electrolyte abnormalities
  5. Hepatotoxicity
  6. Hyperuricemia
  7. Optic Neuritis (as well as Papilledema, cerebral blindness)
  8. Ototoxicity
    1. May be irreversible
    2. Higher risk in patients with TMPT gene variant (thiopurine-S-Methyltransferase)
  9. Myalgias
  10. Nephrotoxicity
    1. Reduced when amifostine is added to Ovarian Cancer regimen
  11. Peripheral Neuropathy
  12. Secondary Malignancy
  13. Vomiting (excessive)

VII. Safety

  1. Avoid in Lactation
  2. Pregnancy Category D
    1. Avoid in Pregnancy (all trimesters)
    2. Use reliable Contraception
  3. Age >65 years
    1. Increased risk of nephrotoxicity, Bone Marrow suppression, Peripheral Neuropathy
  4. Monitoring
    1. Complete Blood Count
    2. Electrolytes
    3. Renal Function tests
    4. Liver Function Tests
    5. Audiometry

VIII. Drug Interactions

  1. Phenytoin
    1. Cisplatin decreases levels
  2. Aminoglycosides
    1. Increased risk of nephrotoxicity

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Related Studies

Ontology: Cisplatin (C0008838)

Definition (MSHCZE) Cytostatikum s podobným použitím jako karboplatina. Má výrazný emetogenní účinek, snižuje funkci ledvin (hydratace), může tlumit krvetvorbu. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI) An alkylating-like inorganic platinum agent (cis-diamminedichloroplatinum) with antineoplastic activity. Cisplatin forms highly reactive, charged, platinum complexes which bind to nucleophilic groups such as GC-rich sites in DNA inducing intrastrand and interstrand DNA cross-links, as well as DNA-protein cross-links. These cross-links result in apoptosis and cell growth inhibition.
Definition (NCI_NCI-GLOSS) A drug used to treat many types of cancer. Cisplatin contains the metal platinum. It kills cancer cells by damaging their DNA and stopping them from dividing. Cisplatin is a type of alkylating agent.
Definition (CSP) inorganic, water soluble platinum complex; radiation sensitizing agent.
Definition (MSH) An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle.
Definition (PDQ) An inorganic platinum agent (cis-diamminedichloroplatinum) with antineoplastic activity. Cisplatin forms highly reactive, charged, platinum complexes which bind to nucleophilic groups such as GC-rich sites in DNA, inducing intrastrand and interstrand DNA cross-links, as well as DNA-protein cross-links. These cross-links result in apoptosis and cell growth inhibition. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39515&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39515&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C376" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Inorganic Chemical (T197)
MSH D002945
SnomedCT 387318005, 303282001, 57066004
LNC LP16079-3, MTHU016242
English cis Diamminedichloroplatinum, cis Platinum, cis-Diamminedichloroplatinum, cis-Diamminedichloroplatinum(II), cis-Dichlorodiammineplatinum(II), cis-Platinum, Cisplatin, Diamminodichloride, Platinum, Dichlorodiammineplatinum, Platinum Diamminodichloride, cis platinum compound, Platinum, diamminedichloro-, (SP-4-2)-, (SP-4-2)-Diamminedichloroplatinum, Platinum, Diaminedichloro-, cis- (8CI), cis-diammine-dichloroplatinum, cisplatinum, Cis-diamminedichloroplatinum, Cis-dichloroammine Platinum (II), Cis-platinous Diamine Dichloride, Cismaplat, Cis-diamminedichloro Platinum (II), Cisplatina, Platinoxan, Cysplatyna, Cis-platinum II Diamine Dichloride, Peyrone's Chloride, Peyrone's Salt, DIAMMINEDICHLOROPLATINUM CIS 02, DICHLORODIAMMINEPLATINUM CIS 02, Diaminedichloroplatinum, cisplatin, cisplatin (medication), Cisplatin [Chemical/Ingredient], CISPLATIN, cis platinum, C.I. 77795, Platinum Metallicum, CISplatin, cis diamminedichloroplatinum, cis dichlorodiammineplatinum, platinum diamminodichloride, Diaminedichloroplatinum (substance), CDDP - Cisplatin, DDP, cis-DDP, cis-Diaminedichloroplatinum, cis-Platinum II, cis-Platinum compound, Cisplatin product, Cisplatin (product), Cisplatin (substance), CPDD, CACP, PDD, cis-platinum, cis-platinum II, cis-Platinum compound, NOS, CDDP, Cis-diammine-dichloroplatinum, Cis-diamminedichloridoplatinum, Cis-platinum II, Cis-platinum, Cisplatinum
French cis-Diamminedichloroplatine(II), cis-Platine, Cisplatine
Swedish Cisplatin
Czech cisplatina
Spanish cis-DDP, diclorodiaminoplatino, cis-diclorodiaminoplatino, diaminodicloroplatino, diaminodicloroplatino (sustancia), cis-diaminedicloroplatino, cisplatino (producto), cisplatino (sustancia), cisplatino II, cisplatino, compuesto de cisplatino, Cisplatino, Diaminocloruro de Platino, cis-Diaminodicloroplatino (II), cis-Diclorodiaminoplatino (II)
Finnish Sisplatiini
Russian PLATINY DIAMINDIKHLORID, TSISPLATIN, TSIS-DIAMINDIKHLORPLATINA (II), ПЛАТИНЫ ДИАМИНДИХЛОРИД, ЦИС-ДИАМИНДИХЛОРПЛАТИНА (II), ЦИСПЛАТИН
Japanese ジクロロジアミン白金, シス-ジクロロジアミン白金(2), プラチナムジアミノジクロリド, ジクロロジアンミン白金, シスプラチン, シス-ジアミンジクロロ白金(2)
Italian Cis-diaminodicloro platino(II), Diammino-dicloro-platino, Cis dicloro diamino platino, Cis dicloro diamino platino(II), cis-Platino, Diammino dicloro platino, Cisplatino
German DICHLORODIAMMINEPLATIN CIS 02, DIAMMINDICHLOROPLATIN CIS 02, Cisplatin, Platindiammindichlorid, cis-Diammindichloroplatin (II), cis-Dichlorodiamminplatin (II)
Croatian CISPLATIN
Polish Cisplatyna, Dichlorodiaminoplatyna
Norwegian Cisplatin
Portuguese Cisplatino, Diaminodicloroplatina, cis-Diaminodicloroplatina (II), cis-Diclorodiaminoplatina (II)