The aim of this study is to analyze current trends in the clinical utilization of platinum-based chemotherapeutics, emerging prescribing preferences, and recent advancements. Additionally, it seeks to identify opportunities for expanding and optimizing platinum-based chemotherapy to improve treatment outcomes and reduce adverse reactions.
A three-step approach was applied: (1) comparative examination of current clinical practice based on approved pharmacotherapeutic guidelines from the European Society for Medical Oncology (ESMO), the National Comprehensive Cancer Network (NCCN), U.S. and other relevant organizations; (2) qualitative and quantitative analysis of utilization data sourced from publicly available databases and hospital pharmacies; (3) review of ongoing clinical trials along with insights from literature and expert opinions.
Cisplatin, carboplatin and oxaliplatin are platinum-based antineoplastic drugs with a long established role in treating various cancers. Analysis of ESMO and NCCN guidelines revealed that 64% and 72%, respectively, recommend their use in combination protocols, with consideration of patient-specific factors, safety profiles, and comorbidities. Their clinical use is quite stable with a trend toward increased utilization probably due to rising rates of diagnosed cancer patients. For instance, in Bulgaria, the overall utilization of platinum-based drugs increased from 75,275 packages in 2021 to 96,840 in 2024. Among these medications, oxaliplatin accounted for the highest average monthly number of treated patients.
Despite their widespread use, platinum-based therapies face challenges, including dose-limiting side effects and low response rates in certain cancer types. To address these issues, extensive research is focused on improving their toxicological profile, identifying optimal combinations (for example integrating monoclonal antibodies and other immunotherapies) and modifications, and refining dosage forms to better meet unmet medical needs and enhance patient outcomes.
Undoubtedly, despite the innovations in oncology care and the challenges related to their application, platinum chemotherapeutics remain an essential component of treatment regimes worldwide.