Cisplatin
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | DRUG-CISPLATIN |
|---|---|
| Tipo | Fármaco |
| Aliaces | CDDPPlatinolAQ de platinolCis-DDPЦисплатин |
| Situación | reviewed 2026-04-26 | pending_clinical_signoff |
| Enfermedades | DIS-ADRENOCORTICAL-CARCINOMA DIS-BURKITT DIS-CERVICAL DIS-CHOLANGIOCARCINOMA DIS-ESOPHAGEAL DIS-GASTRIC DIS-HNSCC DIS-LARYNGEAL DIS-MCL DIS-MESOTHELIOMA DIS-NPC DIS-NSCLC DIS-PENILE-SCC DIS-SCLC DIS-TESTICULAR-GCT DIS-UROTHELIAL DIS-VULVAR-VAGINAL-SCC |
| Fuentes | SRC-ESMO-ESOPHAGEAL-2024 SRC-NCCN-ESOPHAGEAL-2025 |
Datos sobre drogas
| Clase | Agente alquilante de platino (primera generación) |
|---|---|
| Mecanismo | Square-planar platinum(II) coordination complex. After cellular uptake and aquation (Cl displaced by water in low-chloride intracellular environment), the activated species forms intra- and inter-strand DNA cross-links, predominantly 1,2-d(GpG) and 1,2-d(ApG) adducts. These adducts distort the DNA helix, blocking replication and transcription, and trigger apoptosis when not repaired. Resistance mechanisms include enhanced nucleotide excision repair, glutathione detoxification, and reduced cellular uptake (CTR1 transporter). Backbone for esophageal CRT, head-and-neck CRT, NSCLC, gastric (legacy), cervical, ovarian, testicular germ-cell, and bladder. |
| Dosificación típica | Esophageal definitive CRT (cisplatin/5-FU): cisplatin 75 mg/m² IV days 1, 29 + 5-FU 1000 mg/m²/d CIV days 1-4 and 29-32. Head-and-neck CRT: 100 mg/m² IV q21d × 3 cycles (high-dose) or 40 mg/m² weekly with RT. NSCLC (cisplatin/etoposide CRT): 50 mg/m² IV days 1, 8, 29, 36. NSCLC adjuvant (cisplatin/vinorelbine): 80 mg/m² IV day 1 q21d × 4. Testicular BEP: 20 mg/m² IV days 1-5 every 21 d × 3-4 cycles. Cervical CRT: 40 mg/m² IV weekly with RT (typically 5-6 cycles). Gastric (legacy ECF/EOX): 60-80 mg/m² IV q21d (FLOT preferred now). Mandatory hydration: ≥1-2 L NS pre-dose + 1-2 L post; mannitol diuresis or furosemide for high-dose schedules; Mg + K replacement. |
| Ucrania registrada | Cierto |
| NSZU reembolsado | Cierto |
| Ucrania verificada por última vez | 2026-04-27 |
Advertencias
- Toxicidad renal acumulativa — hidratación obligatoria + sustitución de electrolitos
- Náuseas/vómitos graves (muy emetógenos — nivel HEC)
- Ototoxicidad (pérdida auditiva de alta frecuencia irreversible; basal + audiometría serial)
- Reacciones anafilácticas (epinephrine, antihistamínicos, corticosteroides a mano)
- Mielosupresión (con horarios de dosis altas)
Notas
Mandatory hydration ≥3 L pre-dose + 24 h post; Mg / K pre-emptive supplementation. Consider carboplatin substitution for CrCl 50-60 or pre-existing hearing loss. Highly-emetogenic chemotherapy (HEC): ondansetron + dexamethasone + NK1-RA (aprepitant or fosaprepitant) + olanzapine premedication required (NCCN antiemesis v1.2025). Baseline + serial audiometry (esp. pediatric / younger adult patients). Uridine triacetate is NOT an antidote (FU only).
Utilizado por
Indicación
IND-LARYNGEAL-RM-1L-EXTREME- IND-LARYNGEAL-RM-1L-EXTREMEIND-LARYNGEAL-RM-1L-PEMBRO-CHEMO- IND-LARYNGEAL-RM-1L-PEMBRO-CHEMO
Esquema terapéutico
REG-BEP-GCT- BEP (bleomycin + etoposide + cisplatin, tumor de células germinales)REG-CISPLATIN-5FU-PENILE- Cisplatin + 5-fluorouracil (metastatic penile SCC, 1L)REG-CISPLATIN-CONCURRENT-RT-LARYNX- Cisplatin concurrent with definitive RT (larynx-preservation CRT; RTOG 91-11)REG-CISPLATIN-GEMCITABINE-UROTHELIAL- Cisplatin + gemcitabine (neoadj urotelial + metastásico)REG-CISPLATIN-RADIOSENS- Cisplatin radiosensitization (concurrent with EBRT + brachytherapy)REG-DURVA-GEM-CIS-CHOLANGIO- Durvalumab + gemcitabine + cisplatin (TOPAZ-1) — 1L cáncer de tracto biliar avanzadoREG-EDP-M-ACC- EDP-M (etoposide + doxorrubicina + cisplatin + mitotane) — FIRM-ACT régimenREG-EP-CONCURRENT-RT-SCLC-LIMITED- Etoposide-platino + torácico simultáneo RT (limitada) SCLC)REG-EP-GCT- EP (etoposide + cisplatin, tumor de células germinales)REG-EXTREME-HNSCC- EXTREME (cetuximab + cisplatin/carboplatin + 5-FU; HNSCC R/M, 1L)REG-GEMCITABINE-CISPLATIN-CHOLANGIO- Gemcitabine + cisplatin (cáncer del tracto biliar avanzado, 1L — ABC-02)REG-MCL-INTENSIVE-RDHAP-AUTOSCT- MCL: alternating R-CHOP/R-DHAP induction followed by an ASCT pathway (MCL Younger-based)REG-NIVO-CHEMO-ESCC- Nivolumab + quimioterapia platina/fluoropirimidina (ESCC)REG-NPC-GC-CAMRELIZUMAB- Camrelizumab + gemcitabine + cisplatin (CAPTAIN-1d) — 1L recurrente/nasofaringe metastásica...REG-NPC-GC-INDUCTION-CCRT- Inducción gemcitabine-cisplatin (GC) + simultáneamente cisplatin quimioterapia (IMRT) — Locor...REG-NPC-GC-TORIPALIMAB- Toripalimab + gemcitabine + cisplatin (JUPITER-02) — 1L recurrente/nasofaringe metástica...REG-OSI-PEM-PLATINUM-NSCLC- Osimertinib + pemetrexed + carboplatin/cisplatin (FLAURA-2 regimen, EGFR-mut NSCLC, 1L)REG-PEMBRO-CHEMO-HNSCC-1L- Pembrolizumab + 5-FU + platino (HNSCC R/M, 1L; PD-L1 CPS ≥1)REG-PEMBRO-CHEMO-NEOADJ-NSCLC- Pembrolizumab + cisplatin-based chemo (NSCLC neoadjuvant; KEYNOTE-671)REG-PEMBRO-CISPLATIN-5FU-ESOPH- Pembrolizumab + cisplatin + fluorouracilREG-PEMBRO-GEM-CIS-CHOLANGIO- Pembrolizumab + gemcitabine + cisplatin (KEYNOTE-966) — 1L cáncer de tracto biliar avanzadoREG-PEMETREXED-CISPLATIN-MPM- Pemetrexed + cisplatin (malignant pleural mesothelioma, 1L)REG-RDHAP-BURKITT- R-DHAP (Rituximab + Dexamethasone + HD- Citarabina + Cisplatin) × 2-3 ciclos → ASCT- ¿Qué?REG-TIP-GCT-SALVAGE- TIP (paclitaxel + ifosfamide + cisplatin, salvamento de tumores de células germinales)REG-TIP-PENILE- TIP (paclitaxel + ifosfamide + cisplatin, pene SCC)REG-TRASTUZUMAB-CHEMO-TOGA- Trastuzumab + capecitabine + cisplatin (TOGA / KEYNOTE-811)