Cisplatin

What Is Cisplatin?

Cisplatin is a chemotherapy drug used to treat various types of cancer, including mesothelioma. It’s especially effective when combined with another chemo drug, Alimta, which is the brand name for pemetrexed. This combination is a first-line treatment for pleural mesothelioma. 

Key Facts About Cisplatin

1. Cisplatin is frequently given in combination with Alimta (pemetrexed) to disrupt tumor cell growth.
2. Cisplatin is given via an IV, or intravenously. 
3. Cisplatin is used to treat many different types of mesothelioma. It can treat pleural, peritoneal, biphasic, epithelioid and sarcomatoid types of mesothelioma.
4. The generic name for this drug is cisplatin. It’s also known as DDP, cis-DDP and cis-Platinum II. There were brand name versions, Platinol and Platinol-AQ, but both were discontinued and are not longer available.

Cisplatin attacks cancer cells and prevents them from dividing. It’s commonly used to treat pleural and peritoneal mesothelioma, two forms of this rare and aggressive cancer.

Many pharmaceutical companies make cisplatin. These include: Accord Healthcare, Athenex Pharmaceutical Division, LLC, BluePoint Laboratories, Fresenius Kabi USA, LLC, Gland Pharma Limited, Teva Parenteral Medicines, Inc., West-Ward Pharmaceuticals Corporation and WG Critical Care, LLC.

How Is Cisplatin Used to Treat Mesothelioma?

Cisplatin is often combined with other drugs, such as Alimta (pemetrexed) or the immunotherapy drug Opdivo, to treat pleural mesothelioma. Combination therapies with cisplatin have improved patient survival rates.

Dr. J. Marie Suga, a leading oncologist and medical director at Kaiser Permanente Clinical Trials Program, tells us the way combination therapies with cisplatin help patients live longer is that they can more effectively target cancer cells. Michael Cole, a mesothelioma survivor, shares with us, “I’ve had surgical procedures, chemotherapy using Alimta and cisplatin and immunotherapy using Opdivo.”

Cisplatin With Alimta (Pemetrexed) for Pleural Mesothelioma

For people with pleural mesothelioma, cisplatin and Alimta (pemetrexed) are typically given together in their chemo regimens. These drugs work cooperatively to stop cancer cell growth. Mesothelioma clinical trials show people receiving this combo treatment have better outcomes and live longer than those receiving cisplatin alone. 

People typically receive cisplatin with Alimta via IV every 21 days. The dose and number of cycles they’ll receive depends on their response and side effects. A recent study demonstrated a survival advantage of several months for people treated with the cisplatin-pemetrexed combo.

Cisplatin and Doxorubicin for Peritoneal Mesothelioma

Cisplatin is also often used alongside another chemo drug, doxorubicin, to treat peritoneal mesothelioma. This combo helps treat cancer in the abdominal cavity. 

It’s particularly used in procedures where heated chemo is used. Heated chemo is used to wash the abdomen after tumors are surgically removed in hyperthermic intraperitoneal chemotherapy. HIPEC is commonly used to treat peritoneal mesothelioma. 

People undergoing this treatment may live longer than those not receiving cisplatin in their regimen. A 2024 study showed doxorubicin plus high cisplatin doses can shrink tumors 50%.

What Can Mesothelioma Patients Expect During Cisplatin Treatment?

Cisplatin is usually given through an IV infusion every 3 weeks. Depending on the specific regimen, treatment sessions can last a few hours. Most patients tolerate cisplatin well, but some may experience side effects. 

People usually have 4 to 6 treatments over 3 to 6 months as outpatients. After the first infusion, patients take a 3-week break before the next personalized treatment.

It’s important to stay hydrated during treatment. Watch for signs of infection or complications. Health care providers monitor blood cell levels, as well as kidney and liver functions. 

What Are the Benefits of Cisplatin for Mesothelioma?

Cisplatin offers several benefits for people with mesothelioma. The most significant is its ability to improve survival rates, particularly when used in combination with Alimta. This treatment regimen often extends life expectancy by several months. 

Sean Marchese, a registered nurse and mesothelioma expert, explained that while some patients experience challenging effects, the benefits outweigh these challenges for many patients. “Cisplatin’s main goal is to improve quality of life. Smaller tumors improve breathing and cause less pain and discomfort. On chemo, most patients feel better and can do more,” Marchese said.

Side Effects of Cisplatin

Like all chemo drugs, cisplatin can cause side effects such as fatigue and nausea. Though less common, more serious side effects can also occur. For example, chemo agents can harm the central nervous system, causing effects such as “chemo brain.” Headaches and psychological disturbances are also possible.

Possible Cisplatin Side Effects

• Black stools
• Changes in taste
• Chills
• Diarrhea
• Dizziness
• Fatigue
• Fever
• Hair loss
• Hearing loss
• Kidney damage
• Low red blood cells (anemia)
• Low white blood cells (neutropenia)
• Nausea
• Numbness or tingling in the fingertips and toes
• Rash
• Seizures
• Shortness of breath or wheezing
• Swelling of the feet or ankles
• Unusual bruising or bleeding
• Vomiting

This medication can quickly impact kidney function, possibly leading to chronic kidney disease. The FDA highlights possible kidney damage and hearing loss with box warnings, formerly known as “black box warnings.” 

Bone marrow suppression can also occur, reducing red and white blood cells. This can cause anemia and increase the risk of infection. 

Managing Side Effects

While cisplatin side effects are common, there are ways to manage them. Some helpful strategies include staying hydrated, eating small meals throughout the day and engaging in light physical activity. 

Tips for Managing Cisplatin Side Effects

1. Ask your doctor about anti-nausea and other medicines that can help with effects.
2. Balance rest and light exercise, such as short walks, to help with fatigue.
3. Drink plenty of water to stay hydrated.
4. Eat small meals throughout the day. (Soft, nonacidic foods help if you have mouth sores. Plastic utensils can help if food tastes metallic.)
5. Some people have found alternative medicine helpful. But, this can sometimes negatively affect or interact with cisplatin. Speak with your doctor first.

“I know that when I had chemo, they had better drugs than in the past,” mesothelioma survivor Michael Cole said. “There are more tools to manage side effects than what they had only a few years ago.”

Dr. Raja Mudad, medical director of the chemotherapy unit at the Sylvester Comprehensive Cancer Center in Miami, said, “Most patients have heard about side effects. They’re often wary of chemo because of this misconception. We have better drugs to prevent side effects now. Most patients don’t have many side effects from chemo.”

Who Is a Candidate for Cisplatin?

Cisplatin is generally recommended for people diagnosed with mesothelioma who are in relatively good health and can tolerate chemo. Oncologists assess each individual patient’s health to determine if cisplatin is a suitable treatment option for them. 

This drug may not be recommended for patients with certain pre-existing conditions, such as kidney problems or hearing loss. Those with coexisting conditions are less likely to tolerate cisplatin.

Healthy Systems Needed for Eligibility

• Bone marrow
• Hearing
• Heart function
• Kidney function
• Nerve function

Those with a platinum allergy may experience serious reactions to the drug. Inform your doctor if you’ve had any reactions to platinum or platinum-based medications. 

Pregnant individuals generally aren’t eligible. Cisplatin can harm developing fetuses. The drug also may negatively impact breast milk. If you’re breastfeeding, consult your doctor.

Common Questions About Cisplatin for Mesothelioma

Can cisplatin cure mesothelioma?

There is no cure for mesothelioma yet. However, cisplatin, when used with other drugs, such as other types of chemo or immunotherapy, has helped patients achieve remission.

How long does a cisplatin chemotherapy session last for mesothelioma patients?

Usually, the drug is administered via IV for 1-2 hours. However, some experts say a slower infusion could reduce side effects. An infusion time of 6-8 hours has even been proposed.

Can cisplatin be used for all types of mesothelioma?

Yes, cisplatin is used to treat all 4 subtypes of mesothelioma: Pleural, peritoneal, pericardial and testicular.

How is cisplatin different from other chemo drugs used to treat mesothelioma?

Cisplatin has worse side effects than some other chemotherapy drugs. While considered highly toxic, it’s still used widely. It works well for mesothelioma patients when used with other drugs.

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