Vetdrugs 2.0Cisplatin is a platinum-containing cytotoxic agent used for selected solid tumors, particularly in dogs. It has been used as adjuvant chemotherapy for canine osteosarcoma and in protocols for several carcinomas. Local intralesional treatment also has a role in equine skin tumors. Its antitumor activity resembles that of alkylating agents, although its DNA binding is mediated by platinum.
Group
Platinum antineoplastic
Mechanism of Action
Intracellular activation of cisplatin generates reactive platinum complexes that bind mainly to purine bases in DNA. Formation of intrastrand and interstrand cross-links distorts the DNA helix, interferes with replication and transcription, and activates damage-response pathways that can trigger apoptosis. Cisplatin is cell-cycle nonspecific, with cytotoxicity related to the accumulation and cellular processing of DNA lesions.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Cancer chemotherapy | Reference only | IV | 60–70 mg/m² IV every 3–4 weeks with fluid diuresis. The body-surface-area regimen is outside the calculator. | |
| Transitional or squamous cell carcinoma | Reference only | IV | 40–50 mg/m² IV every 21–28 days, with saline hydration and antiemetics. | |
| Osteosarcoma | Reference only | IV | 70 mg/m² IV every 21 days for four treatments, with saline hydration and antiemetics. | |
| Alternative carcinoma or sarcoma chemotherapy | Reference only | IV | 30–70 mg/m² IV over 20 minutes to several hours every 3–5 weeks, with saline diuresis before and after treatment. Do not substitute a carboplatin dose. | |
| Pleural effusion palliation | Reference only | PO | Intracavitary cisplatin 50 mg/m² diluted in saline to 250 mL/m² after IV saline 10 mL/kg/hour for four hours. Warm to body temperature, remove pleural fluid through a sterile catheter and instill slowly; repeat every 3–4 weeks if indicated, stopping after four treatments when resolved. Intracavitary route is not supported by the calculator. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Intralesional skin-tumor treatment | Reference only | PO | A historical emulsion uses 10 mg cisplatin powder with 1 mL water and 2 mL medical-grade sesame oil (approximately 3.3 mg/mL). Inject 1 mg/cm³ tumor volume in multiple planes 0.6–1 cm apart, including a 1–2 cm treatment margin where appropriate. Repeat every two weeks for four treatments; this is a tumor-volume procedure, not body-weight dosing. |
Indications
- Adjuvant chemotherapy for canine osteosarcoma after definitive local tumor treatment.
- Treatment of selected canine carcinomas and other solid tumors, including squamous cell, nasal, thyroid and urothelial carcinomas within tumor-specific protocols.
- Intralesional treatment of equine cutaneous tumors, including sarcoids and squamous cell carcinoma.
- Specialist intracavitary treatment for palliation of selected malignant effusions in dogs.
Contraindications
- Cats: potentially fatal pulmonary toxicosis.
- Use cautiously with renal disease.
- Significant renal impairment, marrow suppression or platinum hypersensitivity; fluid loading requires caution with heart failure.
Interactions
- Avoid other nephrotoxic agents.
Adverse effects
- Nephrotoxicity
- Severe vomiting
- Thrombocytopenia
- Potassium and magnesium depletion
Toxicity
Cats develop species-specific severe pulmonary toxicity. Kidney injury is dose-limiting in dogs.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Cisplatin 1 mg/mL injection | Injection | 1 mg / mL | IV |
Monitoring and Administration
Monitor renal function, electrolytes and CBC. Sodium-chloride fluid loading/diuresis and antiemetic therapy are essential parts of the chemotherapy protocol.
Administer within a complete oncology protocol and use cytotoxic handling precautions.
Check CBC, platelets, urinalysis, creatinine and electrolytes before each treatment. Cytopenia, reduced renal clearance or clinically important electrolyte/acid-base disturbance can require withholding or reducing treatment.
Do not refrigerate the described injection; discard precipitated solution. Aluminum-containing needles or equipment can form a black precipitate and must not contact cisplatin.