review · European Journal of Pharmaceutical Sciences
Cisplatin is an effective chemotherapeutic drug used to treat various malignancies, but its clinical utility remains constrained by serious dose-limiting side effects. These adverse reactions primarily include damage to the kidneys, hearing loss, nerve damage, and suppression of bone marrow activity. The underlying biological processes driving this toxicity involve several interconnected cellular mechanisms, notably oxidative stress, inflammation, DNA damage, and programmed cell death. In addition, individual susceptibility varies considerably depending on patient-specific risk factors, particularly pre-existing conditions such as kidney disease, hearing impairment, neuropathy, impaired liver function, and related comorbidities. Emerging therapeutic interventions are being identified to counter these harmful effects. By deploying protective strategies to mitigate adverse reactions, healthcare providers may better optimise cisplatin dosage regimens, ultimately supporting superior patient outcomes and elevating the standard of clinical cancer care.
Cisplatin is a cornerstone of chemotherapy, yet its severe side effects often limit the doses patients can safely tolerate. Understanding the biological triggers of these toxicities and identifying which patients face the greatest risks helps clinicians protect vital organs while preserving the drug's anti-cancer efficacy, paving the way towards safer and more personalised cancer therapies.
The abstract outlines emerging therapeutic strategies to mitigate cisplatin toxicity, which could inform the development of protective adjuvant drugs and clinical decision-support tools for oncologists. Because the text reflects a high-level review of mechanisms and therapeutic concepts rather than specific proprietary products or testing data, the research is at an early conceptual stage of the translation pathway.
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Cisplatin, a widely used chemotherapeutic agent, has proven efficacy against various malignancies. However, its clinical utility is hampered by its dose-limiting toxicities, including nephrotoxicity, ototoxicity, neurotoxicity, and myelosuppression. This review aims to provide a comprehensive overview of cisplatin toxicity, encompassing its underlying mechanisms, risk factors, and emerging therapeutic strategies. The mechanisms of cisplatin toxicity are multifactorial and involve oxidative stress, inflammation, DNA damage, and cellular apoptosis. Various risk factors contribute to the interindividual variability in susceptibility to cisplatin toxicity. The risk of developing cisplatin-induced toxicity could be related to pre-existing conditions, including kidney disease, hearing impairment, neuropathy, impaired liver function, and other comorbidities. Additionally, this review highlights the emerging therapeutic strategies that could be applied to minimize cisplatin-induced toxicities and aid in optimizing cisplatin treatment regimens, improving patient outcomes, and enhancing the overall quality of cancer care.
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DOI: 10.1016/j.ejps.2024.106939
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