Current and future potential roles of the platinum drugs in the treatment of ovarian cancer

The discovery of cisplatin more than two decades ago was the most important therapeutic advance in the treatment of ovarian cancer. Today, cisplatin o r carboplatin in combination with paclitaxel is the most commonly used firs t-line treatment for patients with advanced ovarian cancer. Although platinum drugs remain a critical component of chemotherapy in this type of cancer, cumulative toxicities can limit their use. These toxicitie s include nephrotoxicity, neurotoxicity and ototoxicity with cisplatin and myelosuppression with carboplatin. Although these adverse events can often be managed, the interventions themselves can complicate and add to the cost s of treatment. Importantly, acquired resistance to traditional platinum dr ugs often develops in patients with ovarian cancer and can limit the useful ness of these drugs. Research into new platinum drugs has focused on identifying compounds with improved tolerability profiles and, importantly, those which can circumvent mechanisms of platinum resistance. New platinum drugs currently under deve lopment that are showing promise in ovarian cancer include oxaliplatin, ned aplatin, satraplatin, BBR3464 and ZD0473. If the encouraging in vitro activ ity shown by new compounds, such as ZD0473 and BBR3464, translates into eff icacy in the clinic, they may offer an extended spectrum of activity which includes patients with ovarian cancer resistant to the classical platinum d rugs.