Platinum drugs in the Australian cancer chemotherapy healthcare setting: Is it worthwhile for chemists to continue to develop platinums?

Abstract A cross-sectional descriptive study in Australia was undertaken to examine the current clinical guidelines on the use of platinum-based drugs in cancer treatment. From the Australian EviQ system, data from each chemotherapy protocol was collected with respect to recommended drugs for specific cancer types, drug doses, and dose modifications. Only three drugs have marketing approval: cisplatin, carboplatin, and oxaliplatin, and they are recommended in 119 of the 470 (25%) chemotherapy protocols. The platinums are indicated for the treatment of 24 specific types of cancer (excluding metastatic and non-metastatic variants): head and neck, gynaecological, respiratory, upper gastrointestinal, urogenital, colorectal, and breast cancers, and lymphomas, sarcomas, and multiple myelomas. The recommended doses for cisplatin are between 10 and 100 mg/m 2 , for carboplatin the recommended doses are between 1.5 and 8 area under the curve (AUC), and for oxaliplatin the recommended doses are between 85 and 130 mg/m 2 . A patient may be prescribed a dose reduction of between 25 and 100% when they experience any one of six specific side effects: low platelet levels, low absolute neutrophil count, renal impairment, peripheral neuropathy, mucositis & stomatitis, and diarrhoea. Overall, the results indicate that platinums remain an integral part of chemotherapy and reinforces the need for chemists to continue to develop new platinum drugs and drug delivery strategies, especially for reducing drug side effects.