Cisplatin (Platinol, Platinol®-AQ)  

Cisplatin (also called Platinol and Platinol®-AQ) is a drug used to treat many types of cancer including prostate cancer. It belongs to a group of chemotherapy medicines which are generally known as alkylating agents. It is an anti- cancer or cytotoxic chemotherapy drug. 

Indications: Cisplatin is mainly indicated for the treatment of prostate cancer, lung cancer, breast cancer, head cancer, ovarian cancer, bladder cancer, testicular cancer, cervical cancer and stomach cancer. It is also indicated for treatment of multiple myeloma, melanoma and mesothelioma. 

Dosage: Cisplatin is an intravenous drug which is given through the vein. The drug is generally available in two forms, Injectable solution and powder for injection. The Injectable solution is of 1mg/ml and the powder is available in 10 mg and 50 mgs. The dosage may differ depending upon the types of cancers and the severity of the disease. For instance, for metastatic testicular tumors, usual dosage would be 20 mg/sq.meter/day IV for 5 days/cycle; for advanced bladder cancer, dosage is 50 -70 mg/sq. for 3 to 4 weeks, depending on previous radiation therapy or chemotherapy. In case of metastatic ovarian carcinoma, 75-100 mg/sq. meter for 4 weeks with cyclophosphamide (600 mg/sq. for 4Weeks) is to be administered.  

Dosage for cancer of cervix, prostate, oesophagus, kidney, osteogenic sarcomas, bone marrow transplants are 75-100 mg/sq.meter IV q4Weeks when used with cyclophosphamide and100 mg/sq.meter IV q4Weeks as single agent. The dosage and the number of days may differ as prescribed by the oncologist. 

Contraindications: Contraindications may occur in Cisplatin usage under the following circumstances:  

• If the patient is allergic to any of the components of Cisplatin. 
• If the patient is suffering from nausea and/or constipation 
• If the patient is suffering from any kidney ailments or anaemia, the dosage of Cisplatin may cause reversible effects 
• Any type of vaccinization is not advisable without the doctor’s approval during the treatment.  

Mechanism of Action (MOA):  The drug Cisplatin works in reduction of the cancer cells which grow with the help of testosterones (male hormones) so that the cancer growth gets minimized. This drug is an alkylating agent that work through three mechanisms: 

1. It gets attached to DNA bases causing fragmentation of DNA and preventing their consequent synthesis. 
2. It damages DNA by forming cross-links (inter-atomic DNA bonds) that prevents DNA synthesis 
3. Initiating mispairing of nucleotides that may lead to their mutations.

Interactions: Cisplatin is an alkylating agent and the usage of this drug with other alkylating drugs may cause increased risk of side effects. If a combination of medicines is prescribed by the doctor, the dose and the usage gap of the medicine may differ. Some of the other alkylating medicines are Aldesleukin, Docetaxel, Tobramycin, phenytoin etc. Along with the Cisplatin, Lomustine, Carmustine and streptozocin are also used in treatment for brain tumors. 

Side Effects: Intake of Cisplatin may lead to severe allergic reactions or kidney problems. There may be also problems like loss of hearing (commonly in children), bleeding, weak immunity, bone marrow suppression, vomiting or nausea.  

Over doing of this drug may cause urinary problems, skin rashes, difficult breathing, and dizziness.