Chemotherapy – Oxaliplatin

Transcript

Oxaliplatin is another platinum drug like cisplatin and carboplatin, but whereas a lot of tumor types can kind of switch between carbo and cisplatin, specifically in the stage four setting, because cisplatin for a lot of tumor types is the only standard recommendation for curative therapy whereas carbo can be substituted only if it has to be in those indications, and again, in the stage four setting, if you need to protect your kidneys, Oxaliplatin doesn’t really interchange with carbo nor cisplatin the way those two do. The reason being is it behaves differently and is really most effective in colon cancer. Oxaliplatin is similar to cisplatin and carboplatin in terms of the neuropathy. And the neuropathy is usually what ends up having to stop the Oxaliplatin or delay cycles as they go further. This is specifically the case when you have a concentration of about 850 milligrams per meter squared. When you have delivered that much, you’re at a higher risk of this neuropathy.

However, it does seem to be more reversible than that neuropathy seen with cisplatin. In addition, the thing that is unique about Oxaliplatin is when you drink cold fluids, not a small number of people, for a few days after their therapy, will get basically spasming in their throat, sometimes feeling like they’re choking or have a chest tightness. So for that reason, we recommend being very cautious with touching cold drinks and fluids out of the refrigerator, as well as drinking them, because you may get this sensation. Usually that gets better about a week or two after your Oxaliplatin dose. Unlike the neuropathy with cisplatin, with Oxaliplatin, it can actually be reversible, but it could take up to three to four months. The neuropathy happens usually after a cumulative dose of 850 milligrams per meter squared. When using cisplatin with paclitaxel, which is a common combination we use across multiple tumor types, it is very important to give the paclitaxel before the cisplatin. If the cisplatin is given before the paclitaxel, it can actually elevate the concentrations of paclitaxel, causing more side effects.