Platinum-based agents: Nursing pharmacology

Platinum-based agents, sometimes called platins, are medications that are mainly used to treat cancer.

Broadly speaking, they are part of the bigger “alkylating-like agents” category, and they are primarily used in the treatment of solid tumors, like colon, rectum, lung, ovarian, uterus, testicular, and bladder cancer.

Now, the most commonly used platins include cisplatin, carboplatin and oxaliplatin, which are administered intravenously.

Once administered, platins act as cell-cycle phase nonspecific agents, which means they work by causing damage to the DNA of rapidly dividing cancer cells in all phases of the cell-cycle, ultimately causing their death.

There are three ways they do this. First, they can attach an alkyl group to one of the DNA bases of cancer cells.

Repair enzymes recognize there’s something wrong, so they jump in to replace the alkylated bases and cause DNA fragmentation, which eventually results in DNA damage and cancer cell death.

The second mechanism is the crosslinking of DNA, which means the alkylating agent links two DNA bases together, forming cross-bridges.

Cross-linking prevents DNA from being separated for essential cell processes, like replication or transcription, eventually resulting in cancer cell death and stopping the multiplication of cancer cells.

Cisplatin and carboplatin employ both these mechanisms to exert their antineoplastic effect, while oxaliplatin only seems to act through crosslinking of DNA.