CISPLATIN

(for veterinary information only)

BRAND NAMES: CISPLATINA, PLATINOL-AQ
(Also called cis-Platinum II, cis-DDP, CDDP, DDP, or cis-diamminedichloroplatinum)

BACKGROUND

Cancer is the condition where a significant number of malignant cells have defeated the body’s natural protective mechanisms and have proliferated out of control. This is a bad situation because malignant cells have lost their ability obey the body's regulatory systems and have taken up dividing aggressively and invading other tissues, obliterating normal tissue as they rampantly divide and grow. Some cancers limit their destruction to the area where they started while other cancers invade lymphatic or blood vessels and are carried to distant body locations to begin their cancerous destruction anew.

If a group of cancer cells is localized to one area it may be possible to surgically remove them but treatment is more difficult if they have spread. For this situation, we need medications that can travel to remote body areas and selectively kill cancer cells and leave normal cells alone. We can use the body’s own bloodstream to carry these medications to all the distant sites where cancer may have set up. This kind of treatment is called “chemotherapy.”

Most chemotherapy drugs exploit the fact that cancer cells are rapidly dividing and target cell division. It appears cisplatin cross-links DNA strands thus interfering with cell division though the details of how cisplatin works are not completely understood.

HOW THIS MEDICATION IS USED

Cisplatin is usually used intravenously and is given in conjunction with a process called "diuresis." Diuresis employs intravenous fluids to perfuse the kidneys and assist them in their toxin filtration duties which  means your pet will have to be hospitalized on the day of treatment and receive intravenous fluids for several hours along with the intravenous cisplatin.

In special situations, cisplatin is injected directly into a tumor such as a skin tumor. Cisplatin may also be injected into the chest cavity directly to control cancerous fluid build up in the chest.

Tumors for which cisplatin is effective:

• Squamous cell carcinoma
• Transitional cell carcinoma
• Ovarian carcinoma
• Mediastinal carcinoma
• Osteosarcoma
• Nasal carcinoma
• Thyroid carcinoma

SIDE EFFECTS

Nausea beginning six hours after treatment and persisting for another six hours is expected with use of cisplatin. Anti-nauseal medications can be used to mitigate this side effect and help maintain patient comfort.

Cisplatin can cause kidney damage. Monitoring blood tests are done regularly so that therapy can be modified should kidney parameters elevate.

Bone marrow suppression can also occur on cisplatin. Monitoring tests are also regularly performed to assess the counts of different blood cells.

Cisplatin can interfere with normal hearing by affecting the cochleovestibular nerve which controls hearing. (Cisplatin is what is called an “ototoxic” drug.) Some degree of hearing loss is believed to occur in all humans who use cisplatin. Use of antioxidant supplements may mitigate this side effect but also can reduce the efficacy of cisplatin against the cancer it is combatting. Controversy is ongoing.

In humans, a cisplatin-associated neuropathy has been described (involving a sensory nerve interference). This has not been documented in the dog but several cases of dogs who developed nerve problems (“Lower Motor Neuron” weakness) in their rear legs have been reported. It is not clear if this weakness, though, was part of their cancer syndrome or due to the medication.

INTERACTIONS WITH OTHER DRUGS

Use of cisplat with the diuretic furosemide might increase the possibility of hearing loss.

CONCERNS AND CAUTIONS

Cisplatin concentrates in the liver, intestines and kidneys and is still present in the body six months after treatment but 80% eliminated in urine after 48 hours. Cats are vulnerable to severe pulmonary (lung) side effects and cannot receive cisplatin. Cisplatin cannot be used in patients with renal disease or bone marrow suppression. Patients with renal disease can take another medication called Carboplatin. Cisplatin impairs fertility and causes birth defects. Cisplatin is excreted in body waste for two days following treatment. Gloves should be worn to handle waste. Waste (and gloves) should be sealed in plastic bags before disposal in the regular trash.

(Photocredit: Morguefile.com)

Page last updated: 1/8/2019