Cisplatin

Cisplatin is a platinum-based drug, first discovered by a scientist named Michele Peyrone in 1845. At the time, cisplatin was called Peyrone’s salt or Peyrone’s chloride. However, its cancer-fighting properties weren’t fully recognized until 1969. Today, the chemotherapy agent is used to treat many types of cancer, including mesothelioma, ovarian cancer, and bladder cancer.

Written and Fact-Checked by: Laura Wright

What Is Cisplatin?

Cisplatin is a chemotherapy drug that sometimes goes by the generic name CDDP, or the brand names Platinol and Platinol-AQ. It is known as an anticancer or antineoplastic drug.

Cisplatin is one of the standard drugs used to treat mesothelioma and many other cancers.

In the late 1960s, Barnett Rosenberg accidentally discovered platinum’s ability to disrupt the division of cells like cancer. He was researching cells in magnetic fields when he saw that cells charged by platinum electrodes no longer divided. He initially blamed the magnetic field but later concluded that it was the platinum that disrupted the cells and accurately predicted its ability to fight tumors.

In 1978, the U.S. Food and Drug Administration (FDA) approved the use of cisplatin in the treatment of cancer. Doctors have been routinely using the chemotherapy drug ever since.

How Is Cisplatin Administered?

Cisplatin is injected into the bloodstream through an intravenous (IV) drip. Health care staff will place a small tube into the patient’s vein, which is then connected to a bag that will drip cisplatin and any other chemotherapy drugs being administered.

In some rare cases, drug administration is through a central line. A central line connects directly to a larger vein in the chest or arm. It is used when an IV isn’t possible within the smaller veins that are typically used.

Doctors can prescribe cisplatin in a variety of cycles, ranging from every 3 or 4 weeks to once per week.

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Cisplatin Mechanism of Action

Cisplatin chemotherapy treats mesothelioma by targeting cancer cells and disrupting their ability to properly divide.

Cancer is caused by cells that grow abnormally, dividing and multiplying at rates that are too fast for the body to control. While normal cells stop reproducing when they come into contact with other cells, cancer continues to multiply and grow together, resulting in masses commonly referred to as tumors.

Cisplatin works by preventing cancer cells from being able to multiply.

It finds cells that are dividing at abnormal rates and then disrupts the DNA that gives cells their reproductive instructions. Cells that can’t divide are forced into apoptosis, or “cell suicide.” Simply put, cisplatin damages the cells’ DNA and forces them to die.

However, cisplatin and other chemotherapy drugs aren’t able to tell the difference between cancer cells and healthy cells. As a result, it’s quite common for red and white blood cells to also get destroyed during chemotherapy. This can lead to serious side effects that are sometimes life-threatening

Scientists are currently developing drugs that identify and target cancer cells, but this form of mesothelioma treatment is still undergoing testing and trial.

Cisplatin Drug Combinations

Cisplatin is often used with other cancer treatments.

For example, it is frequently combined with pemetrexed, also called Alimta (pemetrexed). Clinical trials have proven that the two drugs together have better outcomes than either drug on its own.

Patients who receive cisplatin and pemetrexed often take folic acid supplements and steroid tablets and receive vitamin B12 injections.

Cisplatin has also been researched in combination with gemcitabine, which has proven equally effective as cisplatin and pemetrexed. However, this combination has stronger side effects and is more challenging to administer. As a result, oncologists favor combining cisplatin with pemetrexed instead of gemcitabine whenever possible.

Cisplatin can also be combined with vinorelbine, known under the trade name Navelbine, a chemotherapy drug made from periwinkle plants.

One group of researchers has been investigating the use of natural products in combination cisplatin. In a study published in January 2022, they said many natural products have the potential to guard against cisplatin toxicity and reduce or even eliminate its side effects.

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Current Cisplatin Clinical Trials

Cisplatin and pemetrexed are currently recognized as the best combination chemotherapy for mesothelioma and some other types of cancer. As a result, cisplatin and pemetrexed are often used as a baseline when evaluating the efficacy of new chemotherapy drugs and other cancer therapies.

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One Phase III clinical trial underway is comparing cisplatin and pemetrexed against a combination of targeted drugs called nivolumab and ipilimumab. These two drugs interrupt the signal pathways that instruct cells how to behave, ultimately immobilizing the cancer cells.

Unlike chemotherapy, which strikes any cell that multiplies too quickly, targeted drugs seek out specific genetic markers that are only found in mesothelioma or other cancer cells. Many pharmaceutical companies and research centers are investing in these alternative therapies, as they could help fight and potentially cure cancer, with fewer patient side effects.

In addition, several current clinical trials are researching the maximum dosage of cisplatin that can be used in hyperthermic intraperitoneal chemotherapy (HIPEC).

Also referred to as heated chemotherapy, cytoreduction surgery with HIPEC is a process in which the abdomen and organs are soaked in a warm chemo solution after a surgical operation. This procedure targets any microscopic mesothelioma cells left behind.

Surgical oncologists are trying to find out exactly how much cisplatin can be placed directly into the body without causing excessive harm to mesothelioma patients.

Because of its powerful effects against cancer and its long history of use, cisplatin has been involved in hundreds of clinical trials, many of which have focused on mesothelioma patients.

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Cisplatin Side Effects

Cisplatin is an effective but highly toxic chemotherapy drug.

As a result, mesothelioma patients often experience unpleasant side effects and need rigorous monitoring. For example, most patients will need regular blood work to check electrolyte levels and general organ function.

Doctors may also perform physical examinations and order hearing tests to check for symptoms indicating that a dose of cisplatin is too high. In fact, it’s quite common for oncologists to adjust a patient’s dosage as they try to balance benefits with side effects.

Common Side Effects

The most common side effects of cisplatin are:

  • Decreased white and red blood cell counts
  • Hearing loss or tinnitus (ringing in the ears)
  • Kidney toxicity (nephrotoxicity or kidney damage), which is usually temporary
  • Low magnesium, calcium, or potassium levels
  • Nausea and vomiting (for up to 1 week after treatment)

These side effects occur in more than 30% of patients who receive cisplatin.

The lowered red and blood cell counts can lead to other side effects, including:

  • Anemia
  • Bone marrow problems
  • Infection
  • Excessive bleeding

This side effect typically peaks 18-23 days after the initial treatment. Cell counts typically return to normal 39 days after treatment ends.

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Less Common Side Effects

Some less common side effects of cisplatin are:

  • Allergic reaction
  • Hair loss
  • Increase in liver function
  • Loss of appetite
  • Metallic taste in the mouth
  • Peripheral neuropathy (loss of feeling or sensation in the arms or legs)

These side effects occur in 10-29% of patients receiving the drug. 

Though not as common as the other side effects, peripheral neuropathy is a serious condition that progressively worsens with treatment. In some cases, patients may find it difficult to move or walk, and the oncologist may lower the cisplatin dose.

Modifying cisplatin doses is particularly important when these symptoms are present, as peripheral neuropathy is not always reversible.

Additionally, in rare cases, cisplatin may increase a patient’s risk of developing other cancers such as leukemia.

A group of international researchers are studying a way to reduce cisplatin side effects. They have found that istradefylline, an FDA-approved drug used to treat Parkinson’s disease, can lessen cisplatin’s adverse effects without diluting its cancer-fighting properties.

Alternatives to Cisplatin

Cisplatin is recognized as an aggressive treatment option and is often the first choice for mesothelioma patients. However, the severity of side effects means it’s not right for everyone.

A cancer drug known as carboplatin was developed as an alternative to cisplatin. It shares many of the benefits but with lesser side effects. Patients are often prescribed carboplatin over cisplatin if they are older, have other health concerns, or are allergic to cisplatin.

If you’ve been diagnosed with mesothelioma, contact one of our Patient Advocates today to learn more.

Cisplatin FAQs

What are the side effects of cisplatin?

Like many chemotherapy drugs, cisplatin can cause a range of side effects.

Some common side effects include:

  • Decreased white and red blood cell counts
  • Hearing loss
  • Nausea
  • Kidney damage
  • Vomiting

Patients may also experience infection, anemia, and bleeding from the lowered blood cell counts.

Some less common side effects include:

  • Hair loss
  • Loss of appetite
  • Metallic taste in the mouth
  • Peripheral neuropathy (loss of feeling in arms and legs)

How does cisplatin stop DNA replication?

Cisplatin finds cancer cells that are dividing at abnormal rates and then interferes with the DNA that tells the cells to reproduce. This stops cell division and causes the cells to die.

What cancer is cisplatin used for?

The chemotherapy drug cisplatin is used to treat a variety of cancers, including mesothelioma.

Doctors also use the anticancer drug to treat:

  • Bladder cancer
  • Cervical cancer
  • Head and neck cancer
  • Lung cancer
  • Lymphoma
  • Ovarian cancer
  • Testicular cancer
Written by:

Lead Editor

Laura Wright is a journalist and content strategist with more than 14 years of professional experience. She attended college at the University of Florida, graduating magna cum laude with a bachelor’s degree in journalism in 2008. Her writing has been featured in The Gainesville Sun and other regional publications throughout Florida.

10 References
  1. Chemocare. “Cisplatin.” Retrieved from http://chemocare.com/chemotherapy/drug-info/cisplatin.aspx. Accessed on December 1, 2022.

  2. U.S. National Library of Medicine. “cisplatin | Mesothelioma.” Retrieved from https://clinicaltrials.gov/ct2/results?cond=Mesothelioma&term=cisplatin&type. Accessed on December 1, 2022.

  3. Cancer Research UK. “Cisplatin.” Retrieved from http://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/drugs/cisplatin. Accessed on December 1, 2022.

  4. National Cancer Institute. “Clinical Trials Using Cisplatin.” Retrieved from https://www.cancer.gov/about-cancer/treatment/clinical-trials/intervention/C376. Accessed on December 1, 2022.

  5. U.S. National Library of Medicine. “Study of Cytoreductive Surgery and Hyperthermic Intraoperative Chemotherapy With Pemetrexed and Cisplatin for Malignant Pleural Mesotheliomas.” Retrieved from https://clinicaltrials.gov/ct2/show/NCT02838745?term=cisplatin&cond=Mesothelioma&rank=3. Accessed on December 1, 2022.

  6. U.S. National Library of Medicine. “Intracavitary Cisplatin-Fibrin Localized Chemotherapy After P/D or EPP for Malignant Pleural Mesothelioma.” Retrieved from https://clinicaltrials.gov/ct2/show/NCT01644994?term=cisplatin&cond=Mesothelioma&rank=2. Accessed on December 1, 2022.

  7. U.S. National Library of Medicine. “Study of Nivolumab Combined With Ipilimumab Versus Pemetrexed and Cisplatin or Carboplatin as First Line Therapy in Unresectable Pleural Mesothelioma Patients (CheckMate743).“ Retrieved from https://clinicaltrials.gov/ct2/show/NCT02899299?term=cisplatin&cond=Mesothelioma&draw=3&rank=24. Accessed on December 1, 2022.

  8. Chemocare. “Navelbine.” Retrieved from http://chemocare.com/chemotherapy/drug-info/Navelbine.aspx. Accessed on December 1, 2022.

  9. International Journal of Molecular Science. “Pharmacological Effects of Cisplatin Combination with Natural Products in Cancer Chemotherapy.” Retrieved from: https://www.mdpi.com/1422-0067/23/3/1532. Accessed on December 1, 2022.

  10. ScienceDaily. “Existing drug could reduce side effects of popular cancer treatment.” Retrieved from: https://www.sciencedaily.com/releases/2022/11/221130114535.htm. Accessed on December 1, 2022.

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