Platinum complexes in cancer chemotherapy

Cis-diamminedichloroplatinum (DDP) leads the series of platinum coordination complexes and shows definite and striking efficacy against germinal tumors of the testis. Results are also promising in epithelial malignancies including carcinoma of the ovary, bladder, prostate, cervix, and carcinomas of head and neck origin. Toxicities include nephrotoxicity, ototoxicity, and mild to moderate myelosuppression; severe nausea and vomiting have occurred in all schedules tested. After several years of limited clinical investigation, interest in DDP has been renewed by: (a) recent discovery that induced diuresis circumvents the nephrotoxicity seen in earlier trials; (b) subsequent definition of safer larger doses than previous ones; (c) better understanding of pharmacology, and (d) the expectation of synergistic effects with several other anticancer agents. Extensive future use of DDP may be predicted in the treatment of cancer patients although its clinical potential remains to be investigated in a number of tumor types. Major ongoing efforts also include studies on the mechanism of action and pharmacologic properties of DDP, and development of other platinum compounds with improved therapeutic indices.