Oxaliplatin

Trade Name: Eloxatin TM

Drug Type:

Oxaliplatin is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug.  Oxaliplatin is classified as an “alkylating agent.”  For more detail, see “How Oxaliplatin Works” section below.

What Oxaliplatin Is Used For:

  • Oxaliplatin is used to treat colon or rectal cancer that has spread (metastasized), it is often given in combination with other anticancer drugs (fluorouracil and leucovorin).

Note:  If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Oxaliplatin Is Given:

  • It is given by infusion into the vein (intravenous, IV).
  • There is no pill form of Oxaliplatin.
  • The amount of Oxaliplatin you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have.  Your doctor will determine your dosage and schedule.

Oxaliplatin Side Effects:

Important things to remember about Oxaliplatin side effects:

  • Most people do not experience all of the Oxaliplatin side effects listed.
  • Oxaliplatin side effects are often predictable in terms of their onset and duration.
  • Oxaliplatin side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent Oxaliplatin side effects.
  • There is no relationship between the presence or severity of Oxaliplatin side effects and the effectiveness of Oxaliplatin.

Oxaliplatin Infusion Related Side Effects:

  • The feeling of difficulty swallowing, shortness of breath, jaw spasm, abnormal tongue sensation and feeling of chest pressure.  This has been reported rarely (<5%).  It generally starts within hours of Oxaliplatin infusion and often occurs upon exposure to cold.  Avoiding exposure to cold (see self care tips below) helps to prevent this adverse reaction.  Future Oxaliplatin infusions may be given over a longer time frame to help reduce the incidence.

The following Oxaliplatin side effects are common (occurring in greater than 30%) for patients taking Oxaliplatin:

  • Peripheral neuropathy – Numbness and tingling and cramping of the hands or feet often triggered by cold.  This symptom will generally lessen or go away between treatments, however as the number of treatments increase the numbness and tingling will take longer to lessen or go away. Your health care professional will monitor this symptom with you and adjust your dose accordingly.
  • Nausea and vomiting
  • Diarrhea
  • Mouth sores
  • Low blood counts – Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
  • Fatigue
  • Loss of appetite

The following are less common Oxaliplatin side effects (occurring in 10-29%) for patients receiving Oxaliplatin:

  • Constipation
  • Fever
  • Generalized pain
  • Headache
  • Cough
  • Temporary increases in blood tests measuring liver function. (see liver problems).
  • Allergic reaction: a rare side effect, however, call for help immediately if you suddenly have difficulty breathing, your throat feels like it is closing, or chest pain.  Other signs of allergic reaction include rash, hives, sudden cough, or swelling of the lips or tongue.

This list includes common and less common side effects for individuals taking Oxaliplatin. Side effects that are very rare, occurring in less than 10% of patients, are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

How Oxaliplatin Works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.   “Normal” cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normal checks and balances in place that control and limit cell division.  The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink.  They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific.  Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific.  The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective.  This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing.  Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The “normal” cells will grow back and be healthy but in the meantime, side effects occur.  The “normal” cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.  Different drugs may affect different parts of the body.

Chemotherapy (anti-neoplastic drugs) is divided into five classes based on how they work to kill cancer.  Although these drugs are divided into groups, there is some overlap among some of the specific drugs.  The following are the types of chemotherapy:

Oxaliplatin is classified as an alkylating agent.  Alkylating agents are most active in the resting phase of the cell.  These drugs are cell-cycle non-specific.  There are several types of alkylating agents.

  • Mustard gas derivatives:  Mechlorethamine, Cyclophosphamide, Chlorambucil, Melphalan, and Ifosfamide.
  • Ethylenimines:  Thiotepa and Hexamethylmelamine.
  • Alkylsulfonates:  Busulfan.
  • Hydrazines and Triazines: Altretamine, Procarbazine, Dacarbazine and Temozolomide.
  • Nitrosureas:  Carmustine, Lomustine and Streptozocin.  Nitrosureas are unique because, unlike most chemotherapy, they can cross the blood-brain barrier.  They can be useful in treating brain tumors.
  • Metal salts:  Carboplatin, Cisplatin, and Oxaliplatin.