Platinum Compounds

Newer platinum derivatives with differing toxicity profiles have also been tested. Initially, carboplatin was tested in an attempt to reduce the nephrotoxicity of cisplatin and in the hope of non-cross-resistance. The drug showed excellent activity in phase-I and phase-II trials (Ettinger et al. 1994), in newly diagnosed patients in a phase-II window study (Castle-berry et al. 1994), and in combination with etoposide (Frappaz et al. 1992). A recent phase-II trial combined cisplatin with carboplatin in relapsed patients, and showed a 42% response rate (Frappaz et al. 1998). Since myelosuppression is a prominent toxici-ty of carboplatin, several trials were then done incorporating high-dose carboplatin into regimens utilizing hematopoietic stem-cell infusion (Matthay et al. 1999; Kreissman et al. 1997; Park et al. 2000). Ipro-platin produced a 67% response rate in newly diagnosed patients in a phase-II window (Castleberry et al. 1994). Current protocols are open to test oxali-platin, a derivative with decreased nephrotoxicity, which showed activity in neuroblastoma in preclini-cal testing, and is apparently non-cross-resistant with cisplatin and carboplatin (Riccardi et al. 1999; Bleiberg 1998).

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