What Is Cisplatin?

Cisplatin is one of the most widely used chemotherapy drugs for treating mesothelioma. When combined with pemetrexed (Alimta), it leads to the longest survival rates of any chemotherapy combination tested on mesothelioma.

Cisplatin was approved by the U.S. Food and Drug Administration in 1978 to treat testicular cancer and is still used in the treatment of several cancers today.

Cisplatin Information
Name Platinol
Alternate Names Cisplatinum, Platamin, Neoplatin, Cismaplat
Manufacturer Bristol-Myers Squibb
Dosage 75 mg/m² every three weeks
Administration Route Intravenous
Active Ingredient Cisplatin
Drug Class Antineoplastic alkylating agent
Medical Code J9060
Related Drug Carboplatin
Interacting Drug Anti-seizure medications, aminoglycoside antibiotics, amphotericin B, certain diuretics, nalidixic acid, pyridoxine, altretamine
Medical Studies Study of Cytoreductive Surgery and Hyperthermic Intraoperative Chemotherapy with Pemetrexed and Cisplatin for Malignant Pleural Mesothelioma
FDA Warning Renal toxicity, myelosuppression, nausea, vomiting, peripheral neuropathy, ear toxicity, allergic reactions, fetal harm

When it is given alone, cisplatin has a relatively low response rate of less than 15% in most people with pleural mesothelioma. However, when combined with other chemotherapy medications, patients experience improved response rates.

For example, the combination of cisplatin and pemetrexed (Alimta) is the most effective chemotherapy regimen for pleural mesothelioma. Treatment with this therapy has been shown to prolong disease control and survival.

Cisplatin in Mesothelioma Treatment

The basic use of cisplatin is to promote apoptosis, also known as cell death. Cisplatin kills cancer cells, which slows the growth of tumors and may even shrink them in some cases. Chemotherapy may be used in addition to other treatments, such as surgery, immunotherapy and radiation, to control cancer growth and spreading.

I started chemotherapy about three months after the surgery. I was given rounds of cisplatin and Alimta. I was told who it would be between three and six rounds, depending on “what I could tolerate.” I know that when I had the chemotherapy, they had better drugs and more tools to manage the side effects than what they had only a few years earlier.

Throughout treatment, mesothelioma patients receive the combination of cisplatin and pemetrexed every 21 days. The medication pemetrexed is given through an IV and typically takes about 10 to 15 minutes to complete. A dose of cisplatin delivered intravenously follows this step and usually takes about two hours to administer. The dose and number of cycles required will depend on the patient’s response to treatment as well as any side effects experienced.

Side Effects of Cisplatin

Many chemotherapy side effects will subside when treatment ends. If a side effect lingers long after treatment has ended, reach out to your oncologist and explain your condition so they may prescribe medication to help you recover.

Common Side Effects

  • Fatigue
  • Nausea
  • Vomiting
  • Hair loss
  • Diarrhea
  • Hearing loss
  • Kidney damage
  • Changes in taste
  • Low red blood cells (anemia)
  • Low white blood cells (neutropenia)
  • Numbness or tingling in the fingertips and toes

Your medical team can prescribe medications and therapies to lessen the side effects of chemotherapy. For example, anti-nausea medicine helps patients cope with nausea and vomiting.

Patient Advocate Danielle DiPietro

When I first speak with patients, they have a misunderstanding of what side effects to expect from chemo. A lot of people still think hair loss and vomiting. Explaining what most patients experience after chemo or immunotherapy infusion is talked about a lot with patients.

Serious Side Effects

Mesothelioma patients who experience any of the following symptoms after receiving cisplatin should notify their doctor.

Concerning Side Effects

  • Fever
  • Chills
  • Dizziness
  • Diarrhea
  • Seizures
  • Rash
  • Black stools
  • Unusual bruising or bleeding
  • Swelling of the feet or ankles
  • Shortness of breath or wheezing

In some cases, patients receiving this drug can experience extreme side effects such as severe organ damage. The central nervous system can also be affected by chemotherapy agents, leading to side effects such as “chemo brain,” headaches and psychological disturbances.

Cisplatin Studies

In unique cases, high doses of this drug combined with doxorubicin have been effective in shrinking mesothelioma tumors in half. Three small trials using more conventional doses of the two drugs produced positive response rates, but the results await confirmation from larger mesothelioma clinical trials.

A 2016 phase III clinical trial added bevacizumab to cisplatin and pemetrexed with a positive impact on overall survival. Pleural mesothelioma patients who received all three drugs lived an average of 18.8 months compared to 16.1 months for those who only received cisplatin and pemetrexed.

Another trial studying the combination of cisplatin and pemetrexed with the immune checkpoint inhibitor durvalumab found that 57% of patients had no mesothelioma progression at six months.  

In general, chemotherapy drugs disrupt the division of cells that divide quickly, preventing cancer cells from replicating and growing.

In a study of Tumor Treating Fields with pemetrexed and cisplatin or carboplatin, a median survival of 18.2 months was demonstrated.

In 1999, Dr. David Sugarbaker reported a five-year survival rate of 46% in patients with epithelial cell type, lymph nodes free of cancer and clean surgical margins (the latter meaning that little to no cancer cells were detected post-surgery). Most of the participants in this study received cisplatin in combination with doxorubicin and cyclophosphamide after surgery, with radiation therapy following chemotherapy.

In a 1996 study, Sugarbaker and other researchers combined extrapleural pneumonectomy with radiation therapy and chemotherapy with cisplatin, doxorubicin and cyclophosphamide in 120 patients. The overall survival was 45% at two years and 22% at five years.

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