Cisplatin in the management of breast cancer

Cisplatin's role in metastatic breast cancer was initially confined to heavily pretreated patients. It had relatively little activity in these patients, except when administered with high-dose intensity (greater than 33.3 mg/m2/week). More recent trials in previously untreated patients have suggested that cisplatin is an active single agent, with response rates approaching 50% when administered at a dose of 30 mg/m2/d for four days every 3 weeks. Cisplatin has been safely incorporated into combination chemotherapy regimens, and has been used in high-dose regimens in conjunction with autologous bone marrow transplantation. Future trials should examine the use of cisplatin or platinum analogues as first-line therapy in alternating non-cross-resistant regimens, and should attempt to circumvent the dose-limiting toxicities of cisplatin when used in a dose-intensive fashion.