Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Sep;14(3):286-292.
doi: 10.1097/SPC.0000000000000505.

Management of cisplatin-associated toxicities in bladder cancer patients

Antoine Desilets  1 , Jean-Philippe Adam  2   3 , Denis Soulières  1   3   4
Affiliations
Review

Management of cisplatin-associated toxicities in bladder cancer patients

Antoine Desilets et al. Curr Opin Support Palliat Care. 2020 Sep.

Abstract

Purpose of review: Cisplatin remains the treatment cornerstone for bladder cancer, either in neoadjuvant or in metastatic (cisplatin-gemcitabine or dose-dense methotrexate, vinblastine, and doxorubicin). Timely and adequate management of cisplatin's adverse events is important in order to avoid dose reductions, treatment delays, or cessation. Over the last years, several randomized studies and updated guidelines have been published on this subject.

Recent findings: The incidence, physiopathology, risk factors, preventive treatment, and optimal management of such complications will be presented, with special focus on cisplatin-associated nausea and vomiting, acute kidney injury (AKI), hypomagnesemia, neurotoxicity, and ototoxicity.

Summary: Optimal prevention of cisplatin-associated nausea and vomiting requires an aggressive approach with the use of a four-drug prophylactic regimen (NK1 receptor antagonist, 5-HT3 receptor antagonist, dexamethasone, olanzapine). The use of intensive hydration before and after cisplatin infusion has been the mainstay of AKI prevention. The management of hypomagnesemia and neurotoxicity remains largely symptomatic. In an adult population, no therapy has yet demonstrated benefits in the prevention or treatment of platinum-related ototoxicity.

PubMed Disclaimer

References

    1. Einhorn LH, Donohue J. Cis-diamminedichloroplatinum, vinblastine, and bleomycin combination chemotherapy in disseminated testicular cancer. Ann Intern Med 1977; 87:293–298.
    1. Einhorn LH, Williams SD. Chemotherapy of disseminated testicular cancer. A random prospective study. Cancer 1980; 46:1339–1344.
    1. Scagliotti GV, Parikh P, von Pawel J, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage nonsmall-cell lung cancer. J Clin Oncol 2008; 26:3543–3551.
    1. Winton T, Livingston R, Johnson D, et al. Vinorelbine plus cisplatin vs. observation in resected non–small-cell lung cancer. N Engl J Med 2005; 352:2589–2597.
    1. Noronha V, Joshi A, Patil VM, et al. Once-a-week versus once-every-3-weeks cisplatin chemoradiation for locally advanced head and neck cancer: a phase III randomized noninferiority trial. J Clin Oncol 2018; 36:1064–1072.

MeSH terms