Cisplatin
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DRUG-CISPLATIN |
|---|---|
| Тип | Препарат |
| Синоніми | CDDPPlatinolPlatinol-AQcis-DDPЦисплатин |
| Статус | переглянуто 2026-04-26 | очікує клінічного підпису |
| Хвороби | DIS-BURKITT DIS-CERVICAL DIS-CHOLANGIOCARCINOMA DIS-ESOPHAGEAL DIS-GASTRIC DIS-HNSCC DIS-MESOTHELIOMA DIS-NSCLC DIS-SCLC DIS-TESTICULAR-GCT DIS-UROTHELIAL |
| Джерела | SRC-ESMO-ESOPHAGEAL-2024 SRC-NCCN-ESOPHAGEAL-2025 |
Дані про препарат
| Клас | Platinum alkylating agent (first-generation) |
|---|---|
| Механізм дії | 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. |
| Типове дозування | 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. |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | True |
| Остання перевірка для України | 2026-04-27 |
Застереження
- Cumulative renal toxicity — mandatory hydration + electrolyte replacement
- Severe nausea / vomiting (highly emetogenic — HEC tier)
- Ototoxicity (irreversible high-frequency hearing loss; baseline + serial audiometry)
- Anaphylactic-like reactions (epinephrine, antihistamines, corticosteroids on hand)
- Myelosuppression (with high-dose schedules)
Нотатки
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).
Де використовується
Regimens
REG-BEP-GCT- BEP (bleomycin + etoposide + cisplatin, germ cell tumor)REG-CISPLATIN-GEMCITABINE-UROTHELIAL- Cisplatin + gemcitabine (urothelial neoadj + metastatic)REG-CISPLATIN-RADIOSENS- Cisplatin radiosensitization (concurrent with EBRT + brachytherapy)REG-DURVA-GEM-CIS-CHOLANGIO- Durvalumab + gemcitabine + cisplatin (TOPAZ-1) — 1L advanced biliary tract cancerREG-EP-CONCURRENT-RT-SCLC-LIMITED- Etoposide-platinum + concurrent thoracic RT (limited SCLC)REG-EP-GCT- EP (etoposide + cisplatin, germ cell tumor)REG-EXTREME-HNSCC- EXTREME (cetuximab + cisplatin/carboplatin + 5-FU; HNSCC R/M, 1L)REG-GEMCITABINE-CISPLATIN-CHOLANGIO- Gemcitabine + cisplatin (advanced biliary tract cancer, 1L — ABC-02)REG-NIVO-CHEMO-ESCC- Nivolumab + platinum/fluoropyrimidine chemotherapy (ESCC)REG-OSI-PEM-PLATINUM-NSCLC- Osimertinib + pemetrexed + carboplatin/cisplatin (FLAURA-2 regimen, EGFR-mut NSCLC, 1L)REG-PEMBRO-CHEMO-HNSCC-1L- Pembrolizumab + 5-FU + platinum (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 advanced biliary tract cancerREG-PEMETREXED-CISPLATIN-MPM- Pemetrexed + cisplatin (malignant pleural mesothelioma, 1L)REG-RDHAP-BURKITT- R-DHAP (Rituximab + Dexamethasone + HD-Cytarabine + Cisplatin) × 2-3 cycles → ASCT/alloSC...REG-TIP-GCT-SALVAGE- TIP (paclitaxel + ifosfamide + cisplatin, germ cell tumor salvage)REG-TRASTUZUMAB-CHEMO-TOGA- Trastuzumab + capecitabine + cisplatin (TOGA / KEYNOTE-811)