Cisplatin, pharmacology and clinical applications

Cisplatin, cis-diamminedichloroplatium, was firstly discovered of its antitumor activity during a study on the effects of electric current on bacterial growth in 1965 (1) and was later developed to be the cornerstone of modern chemotherapy in early 1970s. Cisplatin plays an important role as one of the most widely used and the most effective chemotherapy for various epithelial cancers. Cisplatin-based chemotherapy is responsible for high cure rate of germ cell tumor, high response and remission rate of ovarian cancer. It is capable of stabilizing various cancers, including non-small cell lung cancer, small cell lung cancer as well as other cancers: head and neck, bladder, stomach, anal and cervix. Cisplatin, when use concurrently with radiotherapy, is a potent radiation sensitizer, therefore, it has been widely used to improve local control in head and neck, lung, cervix, esophagus and anal cancer. The clinical use of cisplatin, however, has been impeded by several adverse effects, such as renal toxicity, electrolyte imbalance, severe nausea with vomiting, neuropathy and ototoxicity. All these unfavorable effects can be minimized by applying some strategies as will be mentioned later. This review article covers cisplatin application on various aspects: pharmacology, current evidence-based clinical use, side effects and prevention.