Cisplatin is a platinum-based chemotherapy drug that is used to treat a variety of cancers, including mesothelioma. It was first approved by the Food and Drug Administration (FDA) in 1978 and is still being used for treatment today. Platinum agents such as Cisplatin have been studied as single agents and in combined regimens for malignant pleural mesothelioma.
As a single agent, Cisplatin has a relatively low response rate of less than 15 percent in most reported pleural mesothelioma cases. However, when combined with other chemotherapy medications, patients have experienced improved response rates. For example, the combination of Cisplatin and Pemetrexed (Alimta) has become the most effective chemotherapy regimen for pleural mesothelioma patients that are not candidates for surgery. Treatment with this therapy has shown to prolong life expectancy and response rates tend to be under 50 percent.
Cisplatin in Mesothelioma Treatment
Throughout treatment, mesothelioma patients receive the combination of Cisplatin and Alimta every 21 days. The medication Alimta is given through an IV and typically takes about 10 to 15 minutes to complete. A dose of Cisplatin follows this step and usually takes about two hours to administer. The dose and number of cycles required will depend on the patient’s response to treatment as well as any side effects experienced.
The basic use of Cisplatin is to promote apoptosis, or cell death. It is recommended to patients who are treated with Cisplatin to start taking a B12 supplement orally one week before treatment begins. Patients will likely receive weekly B12 shots throughout treatment in addition to taking a daily folic acid supplement, which will continue for 21 days after the last treatment cycle. An oral steroid may be prescribed to minimize side effects.
In unique cases, high doses of Cisplatin combined with doxorubicin have been effective in sending mesothelioma into partial remission. It should be noted that three other trials using more conventional doses of Cisplatin and doxorubicin produced positive response rates that are inversely correlated with the number of patients evaluated: 67 percent in 6 patients, 42 percent in 19 patients, and 25 percent in 24 patients. Such statistics indicate that results from a small series of patients should await confirmation from larger clinical trials.
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