The discovery of
cisplatin more than two decades ago was the most important therapeutic advance in the treatment of
ovarian cancer. Today,
cisplatin or
carboplatin in combination with
paclitaxel is the most commonly used first-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 toxicities 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 costs of treatment. Importantly, acquired resistance to traditional
platinum drugs often develops in patients with
ovarian cancer and can limit the usefulness 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 development that are showing promise in
ovarian cancer include
oxaliplatin,
nedaplatin,
satraplatin,
BBR3464 and
ZD0473. If the encouraging in vitro activity shown by new compounds, such as
ZD0473 and
BBR3464, translates into efficacy in the clinic, they may offer an extended spectrum of activity which includes patients with
ovarian cancer resistant to the classical
platinum drugs.