Oxaliplatin – pharmacological properties and clinical efficacy

Oxaliplatin is a new third-generation platinum complex with a 1,2-diaminocyclohexane (DACH) carrier ligand that inhibits DNA synthesis, primarily by causing intrastrand cross-links in DNA. Oxaliplatin has shown in vitro and in vivo efficacy against many tumor cell lines, including some that are resistant to cisplatin and carboplatin. In patients with advanced colorectal cancer, oxaliplatin has been tested as a monotherapy and in combination with other agents. First-line therapy with oxaliplatin and 5-fluorouracil/folinic acid improves response rate and median progression-free survival in patients with advanced colorectal cancer. In addition, oxaliplatin has shown efficacy in patients with platinum-pretreated ovarian cancer with response rates similar to paclitaxel in these patients. Promising results have also been found with oxaliplatin in patients with non-Hodgkin’s lymphoma, pancreatic cancer, breast cancer and other tumors. The main toxicities occurring with oxaliplatin are neurological, haematological and gastrointestinal. The most constant side effect of oxaliplatin is peripheral sensory neuropathy which is manifesting as paresthesia and dysesthesia in the
extremities and is induced or
exacerbated by exposure to cold. This neurological toxicity is dependent on the cumulative dose of oxaliplatin but reversible within a few months of discontinuation of the
treatment in the majority of cases. Unlike cisplatin, oxaliplatin is not associated with renal or auditory toxicity.