{"entity":{"id":"cisplatin","kind":"drug","name":"Cisplatin","aka":[],"tldr":"Cisplatin is the original platinum chemotherapy, discovered by accident in 1965; it cures testicular cancer and makes radiation work better in cervical and head and neck cancer.","summary":"Approved 1978. Weekly cisplatin with radiation has been the backbone of curative cervical cancer treatment since five 1999 trials (the NCI alert), and remains so within KEYNOTE-A18 and INTERLACE. 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(generic)","modality":"Cytotoxic chemotherapy (platinum)","mechanism":"Forms intrastrand DNA crosslinks (1,2-GpG) that block replication and transcription; radiosensitises by inhibiting repair of radiation-induced damage.","approvals":[{"region":"US","year":1978,"indication":"Testicular and ovarian cancer; bladder cancer 1993"}],"mechanismSteps":["Enters the cell and loses chloride ligands to become reactive","Binds adjacent guanines, kinking DNA","Repair fails in dividing or irradiated cells","Apoptosis follows; radiation damage is fixed rather than repaired"],"dosing":{"route":"Intravenous","schedule":"40 mg/m² weekly × 5-6 with radiation (cervical); 75-100 mg/m² every 3 weeks (other tumours)","modifications":"Hold for creatinine clearance <50 mL/min, grade ≥2 neuropathy or hearing loss","monitoring":"Creatinine, magnesium, audiometry, hydration protocol"},"toxicity":[{"event":"Nausea and vomiting","anyGradePct":90,"note":"Without modern antiemetics; ~30% with NK1/5-HT3 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