Cisplatin also

Cisplatin, combined with bleomycin and vinblastine or etoposide, produces cures in most patients with metastatic testicular cancer or germ cell cancer of the ovary. Cisplatin also shows some activity against carcinomas of the head and neck, bladder, cervix, prostate, and lung. 

Studies in laboratory animals have shown that intravenous administration of a high dose of GSH (up to 500 mg/kg) within 30 min of cisplatin injection protects against cisplatin-induced neurotoxicity and nephrotoxicity. Subcutaneous injection of GSH or GSH monoisopropyl ester 2.5 h before injection of cisplatin also protected mice against nephrotoxicity and the acute lethal toxicity of cisplatin, although the GSH ester was far more effective than GSH itself. In these studies, treatment with GSH or GSH ester did not interfere with the antitumor effectiveness of cisplatin, which can be explained by the characteristics of uptake of GSH and cisplatin. GSH and cisplatin are cleared rapidly from the circulation. 

It has been shown that subjects with renal diseases such as IgA nephropathy, membranous prohferative glomerulonephritis, focal sclerosis, and lupus nephritis have levels of endothelin that are significantly higher than those in healthy subjects [209]. Increased circulating ET-1 concentrations and urinary excretion of ET-1 have been observed in patients treated with the nephrotoxic immunosuppressive agents cyclosporine A and tacrolimus (FK-506) [210]. Other nephrotoxic agents, such as cisplatin, also increase urinary excretion of ET [211]. In patients with chronic renal disease, urinary excretion of ET-1 is significantly elevated when compared to normal values (Table 10). 

Cisplatin was discovered during electrolysis experiments of bacterial culture media utilizing platinum electrodes. An electrode product exhibited antibacterial activity at very low concentrations. The product, cisplatin, also revealed antitumor activity. Cisplatin crosslinks DNA via ring atoms of purines and possibly pyrimidines, with the elimination of Cl analogously to the bifunctional alkylating agents discussed. Although c/s-platinum can be... 

The characteristic nephrotoxicity of cisplatin may be reduced by slow intravenous infusion, the maintenance of good hydration, and the administration of mannitol (to maximize urine flow). Bear in mind that cisplatin also has dose-dependent neurotoxic effects. The answer is (B). 

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