As a single agent Pt has good clinical effectiveness in osteogenic sarcoma, as well as in ovarian cancer in the range of 50% as overall response rate, with lower rates (20%) in oesophageal cancer, cervix, head and neck, and germ cell tumors. Most of the reports have dealt with small series, often biased by pretreatment. Combinations with alkylators, antimetabolites and antibiotics have frequently given higher response rates and even cures: especially in germ cell tumors (PVB regimen), osteogenic sarcoma (BMP), ovarian cancer (CP; CAP). The Pt+5-fluorouracil combination yielded high response rates but was unable to produce cures in epidermoid tumors of the head and neck and oesophagus, as well as in ovarian and colonic adenocarcinomas. Combinations with methotrexate and bleomycin proved effective in epidermoid carcinomas of the head and neck and of the uterine cervix, while velban or vindesine or etoposide may reach (with Pt) 40% response rates in lung cancer. In many of the examples cited above the response rate of the combination is higher than the sum of the response rates shown for the optimal use of the components as single agents: reasonably true synergism between Pt and bleomycin, velban, fluorouracil and methotrexate may be suggested. In vitro synergism has been documented between Pt and cytarabine, but only at dose levels non-compatible with intravenous injection: this combination however has been used intraperitoneally. The literature is full of reports of combinations including Pt, used also in tumors where the response rate to Pt alone is far from defined. A rationale from in vitro preliminary studies capable of suggesting the optimal timing and optimal proportions among the different drugs is highly desirable and may lead to improved efficacy and lessened toxicity.
ASJC Scopus subject areas
- Inorganic Chemistry
- Physical and Theoretical Chemistry
- Materials Chemistry