Cisplatin dose intensity

The dose intensity of cisplatin is an important factor in achieving optimal therapeutic results, particularly in ovarian and testicular cancer. Pharmacologic techniques have permitted dose escalation to 200 mg/m2 per cycle. However, further escalations in cisplatin dose are not currently possible due to the development of dose-limiting peripheral neuropathy. Clinical studies are currently in progress with agents such as WR2721 and diethyldithiocarbamate which, in experimental models of cancer, have decreased the toxic effects without altering the antitumor activity of platinum-containing compounds. In addition, carboplatin, a cisplatin analogue, has been shown in phase I and II trials to have a spectrum of activity similar to that of cisplatin, but is not associated with neurotoxicity. These advances should permit further evaluation of the role of platinum dose intensity in the treatment of many different cancers.