Cisplatin and carboplatin are platinum-based anticancer drugs used as first-line chemotherapy for several major cancers, and are among the most widely used generic cancer medicines in India.
Basic Details
- Class: Platinum-based antineoplastic (alkylating-like) agents.
- Cisplatin: The first platinum-based chemotherapy drug, in clinical use since the late 1970s.
- Carboplatin: A second-generation platinum analogue developed to cause less kidney toxicity and fewer side effects than cisplatin, while working through the same mechanism.
- Essential Medicine Status: Both are listed on the WHO Model List of Essential Medicines and India's National List of Essential Medicines (NLEM), and are administered intravenously, usually in combination with other chemotherapy drugs.
How They Work
Platinum compounds bind to purine bases (mainly guanine) in the DNA of rapidly dividing cells, forming intra-strand and inter-strand crosslinks. These crosslinks distort the DNA helix and block replication and transcription, which triggers programmed cell death (apoptosis) preferentially in fast-dividing cancer cells.
Clinical Uses
- First-line or near-first-line treatment for lung, ovarian, cervical, testicular, bladder, and head-and-neck cancers.
- Typically given as part of combination chemotherapy regimens rather than alone.
Significance
- Low-Cost, High-Volume Essential Drugs: Because they are older, off-patent generics on the NLEM, their prices are tightly regulated by the NPPA — which limits how much manufacturers can raise prices even when input costs rise sharply.
- Exposure to Platinum Price Volatility: As platinum-based compounds, their manufacturing cost is directly tied to global platinum prices, a link that is not true of most other essential medicines — making them unusually exposed to commodity-market shocks, as seen in the 2026 shortage.