Mesna does not reduce cisplatin induced nephrotoxicity in the rat

Although mesna afforded protection against the cytotoxicity of cisplatin in Chinese hamster cells, line V-79-753B, in vitro, there was no evidence for protection against nephrotoxicity when this drug combination was examined in the rat. It seems likely that cisplatin-induced nephrotoxicity is mediated by intracellular events in kidney cells which cannot be inhibited by mesna possibly due to its presence within cells in vivo as the stable and unreactive disulphide. On the basis of these data it is unlikely that combinations of mesna and cisplatin will be of therapeutic benefit in man.