Noble metal complexes in cancer chemotherapy.

Platinum coordination complexes form a new class of active anticancer agents in animals and man. Cis-dichlorodiammineplatinum (II), the most widely investigated drug, is now in experimental clinical use against a wide variety of cancers in man. The dose-limiting toxicity in man is renal tubular damage. Hydration of the patient and the use of osmotic diuretics have minimized this effect and allowed higher doses with largely improved responses. Combination chemotherapy with the drug has also produced significant response rates in a variety of cancers. The mode of action of the drug is not yet clear, but most likely involves a primary lesion on nuclear DNA and the stimulation of a host reaction to the cancer. So far, only square planar and octahedral complexes of platinum, with a variety of inorganic and organic ligands, have shown marked activity in animal studies.