Cisplatin for MesotheliomaCisplatin or cis diamminedichloroplatinum (DDP) is a platinum compound
that is widely used for the treatment of a variety of cancers. It
acts like an alkylating agent inside the body, meaning it causes replacement
of hydrogen by an alkyl group in a molcule necessary for tumor growth.
Platinum and platinum complexes are likewise used in industrial chemical
synthesis. Cisplatin, also known by the brand name Platinol®-AQ, is a platinum-containing chemotherapeutic drug. It is a member of a group of chemotherapy drugs known as alkylating agents but the drug itself does not have an alkyl group and it is classified as alkylating-like. Cisplatin is a colorless liquid that is administered via injection or infusion into a vein for the treatment of many types of cancer. The drug works by interfering with the growth of cells that are dividing uncontrollably (cancer cells), causing irreversible damage to the genetic material (DNA), and thus causing the slow growth or death of these cells. It is either used alone or in combination with other chemotherapeutic drugs. Cisplatin is one of the most widely prescribed chemotherapeutic
drugs for many cancers. The drug was approved by the United States
Food and Drug Administration in 1978 for the treatment of testicular,
metastatic ovarian and late-stage bladder cancer. It has been used
to treat other types of cancer including head and neck, esophageal,
stomach, lung, skin, prostate, lymphoma and others (breast, neuroblastoma,
cervical, bone marrow, mesothelioma, osteosarcoma). However, cisplatin
has a number of side-effects including nausea and vomiting, kidney
damage, nerve damage, hearing loss, low blood count, and electrolyte
disturbance. Dosages given to patients depend on the type of cancer
being treated. The drug is available in vials containing 10 mg, 25
mg, or 50 mg of lyophilized powder and in vials containing cisplatin
solution in a concentration of 1mg/1 ml in volumes of 10 ml, 50 ml
and 100 ml. Names
Mechanism of ActionCisplatin is believed to kill cancer cells by binding to DNA and interfering with its repair mechanism, eventually leading to cell death. The first step in the process (after the cisplatin molecule penetrates the cell membrane intact) is for a molecule of water to replace one of the chloride ions. The resulting structure can then bind to a single nitrogen on a DNA nucleotide. Then, the second chloride is replaced by another water molecule and the platinum binds to a second nucleotide. Binding studies of cisplatin with DNA have indicated a preference for nitrogen 7 on two adjacent guanines on the same strand. It also binds to adenine and across strands to a lesser extent. The cisplatin-DNA complex attracts the attention of HMG (high mobility group)-1 and other DNA repair proteins which become irreversibly bound. The resulting distortion to the shape of the DNA prevents effective repair. (The trans isomer of cisplatin is unable to form 1,2 intrastrand links and lacks antineoplastic activity.) Other antineoplastic agents, such as etoposide, contribute to the platinum-DNA-protein complex and thus synergistically reinforce the activity of cisplatin. American Chemical Society on Cisplatin DescriptionCisplatin belongs to the group of chemotherapy medicines known as alkylating agents. It is used to treat cancer of the bladder, ovaries, and testicles. It may also be used to treat other kinds of cancer. Carboplatin is a similar platinum-based chemotherapy agent. Cisplatin interferes with the growth of cancer cells. It can also affect the growth of normal cells, so there are frequently side effects. Some of these may be serious and must be reported to your doctor. Some effects may not occur for months or years after the medicine is used. Before you begin treatment with cisplatin, you and your doctor should talk about the good this medicine will do as well as the risks of using it. Cisplatin is to be administered only by or under the immediate supervision of your doctor. Before Using CisplatinThe following should be considered: Allergies — Tell your doctor if you have ever had any unusual or allergic reaction to cisplatin. Pregnancy — There is a chance that this medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. Cisplatin causes toxic or harmful effects in the fetus in humans and birth defects in mice. In addition, many cancer medicines may cause sterility which could be permanent. Although sterility has not been reported with this medicine, the possibility should be kept in mind. Be sure that you have discussed this with your doctor before receiving this medicine. It is best to use some kind of birth control while you are receiving cisplatin. Tell your doctor right away if you think you have become pregnant while receiving cisplatin. Breast-feeding — Because cisplatin may cause serious side effects, breast-feeding is generally not recommended while you are receiving it. Children — Hearing problems and loss of balance are more likely to occur in children, who are usually more sensitive to the effects of cisplatin.
Other medical problems — The presence of other medical problems may affect the use of cisplatin. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of CisplatinThis medicine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times. While you're on a Cisplatin campaign, your doctor may want you to drink extra fluids so that you will pass more urine. This will help prevent kidney problems and keep your kidneys working well. Cisplatin usually causes nausea and vomiting. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects, especially if they are severe. The dose of cisplatin will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's size, and whether or not other medicines are also being taken. If you are receiving cisplatin at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of cisplatin, ask your doctor. Precautions While Using CisplatinDo not have any immunizations (vaccinations) without your doctor's approval while taking Cisplatin and shortly thereafter. Cisplatin may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth. Cisplatin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
If cisplatin accidentally seeps out of the vein into which it is injected, it may damage some tissues and cause scarring. Tell the doctor or nurse right away if you notice redness, pain, or swelling at the place of injection. Side Effects of CisplatinCheck with your doctor or nurse immediately if any of the following side effects occur: * Less common Check with your doctor as soon as possible if any of the following side effects occur:
* Rare Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: o Nausea and vomiting (severe) o Loss of appetite
After you stop receiving cisplatin, it may still produce some side effects that need attention. During this period of time check with your doctor if you notice any of the following side effects: * Black, tarry stools; blood in urine or stools; convulsions (seizures); cough or hoarseness; decrease in urination; fever or chills; loss of balance; loss of reflexes; loss of taste; lower back or side pain; numbness or tingling in fingers or toes; painful or difficult urination; pinpoint red spots on skin; ringing in ears; swelling of feet or lower legs; trouble in hearing; trouble in walking; unusual bleeding or bruising
If you have mesothelioma, we might be able to help you. Fill out this form. This website is sponsored by Jonathan David* of The
David Law Firm. The David Law Firm is located in The Woodlands, Texas
(Greater Houston Area) and can be reached toll free at 1-800-998-9729
for more information on mesothelioma. Jonathan David is not a medical
doctor. The information on these pages is for the education of mesothelioma
patients and their families regarding potential medical and legal
options. Patients are advised to consult with a medical doctor.
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The
use of chemotherapy in patients with advanced malignant pleural mesothelioma:
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