Oxaliplatin

This is a diaminocyclohexane platinum compound which forms crosslinks in DNA, so inhibiting DNA replication.

Treatment with Oxaliplatin is associated with a 10% probability of an objective response when given alone or in combination with 5-fluorouracil and leucovirin in patients who have already received 5-fluoruracil (1).

NICE recommend the use of oxaliplatin in combination with 5-fluorouracil and folinic acid as an option for the adjuvant treatment of patients with stage III (Dukes? C) (2)

Possible adverse effects include:

• mild paraesthesia/dysaesthesia, generally triggered by cold, occurs in most patients after oxaliplatin infusion and may last a few days
• rarely acute dyspnoea and dysphagia may occur following oxaliplatin infusion - these symptoms generally resolve within a few hours without treatment (3)
• 10-20% of patients develop longer-lasting, severe sensory symptoms secondary to sensory peripheral neuropathy and related to the cumulative dose of oxaliplatin - generally these symptoms resolve after stopping treatment - however associated functional impairment may last for 3-4 months
• diarrhoea is a common adverse effect and may be severe
• neutropenia may occur

The summary of product characteristics should be consulted before prescribing this drug.

Reference:

• Editorial NEJM (2000); 343: 963-964
• NICE (April 2006). Capecitabine and oxaliplatin in the adjuvant treatment of stage III (Dukes' C) colon cancer.
• Drugs and Therapeutics Bulletin (2002); 40(7): 50-2.