Current clinical applications and future developments of platinum-based anticancer drugs

The study evaluated the current patterns of guideline-recommended clinical use, real-world utilization trends, and translational development of platinum-based (Pt-based) drugs through a comparative analysis of national and international pharmacotherapeutic guidelines, national drug utilization data, clinical trials, and emerging research directions. Cisplatin, carboplatin and oxaliplatin continue to play central roles across multiple malignancies and remain widely incorporated into recommended treatment protocols. Across all five guideline sources evaluated, Pt-based therapies were recommended in more than half of the 18 ICD-O topographic categories, with guideline coverage ranging from 55.6% to 83.3%. Real-world utilization data, using Bulgaria as a case study, indicated sustained and increasing use of Pt-based therapies between 2021 and 2024, with oxaliplatin showing the greatest increase. Current clinical trials focus primarily on optimizing established Pt-based regimens through combinations with immunotherapeutics and emerging drug candidates within increasingly personalized multimodal treatment strategies. In parallel, research efforts are directed toward the development of new Pt complexes, exploring next-generation approaches such as multifunctional Pt(IV) prodrugs and Pt-N-heterocyclic carbene compounds, as well as advanced drug-delivery systems, reflecting continued innovation in the field. Overall, Pt-based drugs remain essential in cancer therapy and continue to represent a dynamic area of research in biological inorganic chemistry and translational oncology.