Cisplatin is one of the most widely used chemotherapy drugs for treating mesothelioma. It is commonly combined with pemetrexed (Alimta) as a follow-up treatment to surgery, but can also be administered to pleural mesothelioma patients not eligible for surgery.
Other names: Platinol, Platinol-AQ, DDP, CDDP and cisplatinum
Manufactured by: Bristol-Myers Squibb, Teva Pharmaceuticals, Tocris Bioscience, others
Used or tested in: Germ cell tumors, lymphoma, sarcoma, small cell lung cancer, ovarian cancer and mesothelioma.
Cisplatin was approved by the Food and Drug Administration (FDA) in 1978 and is still used in treatment today.
When it is given alone, cisplatin has a relatively low response rate of less than 15 percent in most reported pleural mesothelioma cases. However, when combined with other chemotherapy medications, patients experienced improved response rates. For example, the combination of cisplatin and pemetrexed (Alimta) is the most effective chemotherapy regimen for pleural mesothelioma patients who are not candidates for surgery. Treatment with this therapy has been shown to prolong life expectancy.
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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 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.
The basic use of cisplatin is to promote apoptosis, or cell death. It is recommended to patients who are treated with it to start taking a B12 supplement orally one week before treatment begins. Patients will likely receive weekly B12 shots throughout treatment in addition to taking a daily folic acid supplement, which will continue for 21 days after the last treatment cycle. An oral steroid may be prescribed to minimize side effects.
In unique cases, high doses of this drug combined with doxorubicin have been effective in sending mesothelioma into partial remission. Three small trials using more conventional doses of the two drugs produced positive response rates, but the results should await confirmation from larger clinical trials.
Promising results were also noted in the combination of cisplatin and gemcitabine in Australia, with a partial response rate of 47.6 percent among 21 patients. Median survival was 41 weeks (about 10 months). Most of the responses were seen in mesothelioma patients diagnosed with the epithelioid subtype, and symptom relief was correlated with response to treatment.
In a previous study, Dr. Sugarbaker and other researchers combined extrapleural pneumonectomy with radiation to the hemithorax and chemotherapy with cisplatin, doxorubicin and cyclophosphamide in 120 patients. The overall survival was 45 percent at two years and 22 percent at five years.
Many of these side effects will subside when treatment ends.
Numbness or tingling in the fingertips and toes
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 alkylating-like agents.
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