Oxaliplatin by itself has modest activity against advanced colorectal cancer.[14] When compared with just 5-fluorouracil and folinic acid administered according to the de Gramont regimen, a FOLFOX4 regime produced no significant increase in overall survival, but did produce an improvement in progression-free survival, the primary end-point of the phase III randomized trial.[15]
Adverse effects
Side-effects of oxaliplatin treatment can potentially include:
Neurotoxicity leading to chemotherapy-induced peripheral neuropathy, a progressive, enduring and often irreversible tingling numbness, intense pain and hypersensitivity to cold, beginning in the hands and feet and sometimes involving the arms and legs, often with deficits in proprioception.[16] This chronic neuropathy may also be preceded by a transient acute neuropathy occurring at the time of infusion and associated with excitation of voltage-gated Na+ channels.[17][18]
In addition, some patients may experience an allergic reaction to platinum-containing drugs. This is more common in women.[19]
Oxaliplatin has less ototoxicity and nephrotoxicity than cisplatin and carboplatin.[16]
Structure and mechanism
The compound features a square planar platinum(II) center. In contrast to other drugs of the platinum-based antineoplastic class of drugs cisplatin and carboplatin, oxaliplatin features the bidentate ligand trans-1,2-diaminocyclohexane in place of the two monodentate ammine ligands. It also features a bidentate oxalate group.[7] The three-dimensional structure of the molecule has been elucidated by X-ray crystallography, although the presence of pseudosymmetry in the crystal structure has caused confusion in its interpretation.[22]
According to in vivo studies, oxaliplatin fights carcinoma of the colon through non-targeted cytotoxic effects. Like other platinum compounds, its cytotoxicity is thought to result from inhibition of DNA synthesis in cells. In particular, oxaliplatin forms both inter- and intra-strand cross links in DNA,[23] which prevent DNA replication and transcription, causing cell death.
History
Oxaliplatin was first synthesized in 1978 at Nagoya City University by Yoshinori Kidani.[24] It was later developed in Europe as a less toxic and more effective alternative to cisplatin. It gained European approval in 1996,[25] and approval by the U.S. Food and Drug Administration in 2002.[26]Generic oxaliplatin was first approved in the United States in August 2009.[27] Patent disputes caused generic production to stop in 2010, but it restarted in 2012.[28][29]
Patent information
Eloxatin was covered by patent numbers 5338874 (expired 7 April 2013), 5420319 (expired 8 August 2016), 5716988 (expired 7 August 2015) and 5290961 (expired 12 January 2013) (see Electronic Orange Book patent info for Eloxatin).[30] Exclusivity code I-441, which expired on 4 November 2007, is for use combination with infusional 5-FU/LV for adjuvant treatment stage III colon cancer patients who have undergone complete resection primary tumor-based on improvement in disease free survival with no demonstrated benefit overall survival after 4 years. Exclusivity code NCE, New Chemical Entity, expired on 9 August 2007.[30]
^ abcdef"Oxaliplatin". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016.
^ abOun R, Moussa YE, Wheate NJ (May 2018). "The side effects of platinum-based chemotherapy drugs: a review for chemists". Dalton Transactions. 47 (19): 6645–6653. doi:10.1039/c8dt00838h. PMID29632935.
^World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
^"FOLFOX". National Cancer Institute. 18 September 2009. Retrieved 26 May 2022.
^"CAPOX". National Cancer Institute. 4 April 2012. Retrieved 26 May 2022.
^"XELOX". National Cancer Institute. 6 January 2012. Retrieved 26 May 2022.
^Bécouarn Y, Ychou M, Ducreux M, Borel C, Bertheault-Cvitkovic F, Seitz JF, et al. (August 1998). "Phase II trial of oxaliplatin as first-line chemotherapy in metastatic colorectal cancer patients. Digestive Group of French Federation of Cancer Centers". Journal of Clinical Oncology. 16 (8): 2739–2744. doi:10.1200/JCO.1998.16.8.2739. PMID9704726.
^de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, et al. (August 2000). "Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer". Journal of Clinical Oncology. 18 (16): 2938–2947. doi:10.1200/JCO.2000.18.16.2938. PMID10944126.
^ abPasetto LM, D'Andrea MR, Rossi E, Monfardini S (August 2006). "Oxaliplatin-related neurotoxicity: how and why?". Critical Reviews in Oncology/Hematology. 59 (2): 159–168. doi:10.1016/j.critrevonc.2006.01.001. PMID16806962.
Graham J, Mushin M, Kirkpatrick P (January 2004). "Oxaliplatin"(PDF). Nature Reviews. Drug Discovery. 3 (1): 11–12. doi:10.1038/nrd1287. PMID14756144. Archived from the original(PDF) on 8 November 2004. Retrieved 19 July 2005.
External links
"Oxaliplatin". National Cancer Institute. 5 October 2006.