TY - JOUR T1 - Thoracic malignancies, cisplatin and renal function JF - European Respiratory Journal JO - Eur Respir J SP - 760 LP - 761 DO - 10.1183/09031936.00160810 VL - 37 IS - 4 AU - J. Nortier AU - J-P. Sculier Y1 - 2011/04/01 UR - http://erj.ersjournals.com/content/37/4/760.abstract N2 - Cisplatin (cis-dichlorodiammine-platinum II or CDDP) is the central drug used in the management of thoracic malignancies. The first trials were published in the 1970s 1, showing activity in lung cancer. Since then it has been shown to improve survival in advanced nonsmall cell lung cancer (NSCLC) 2 and survival and cure in combination with radiotherapy in locoregional NSCLC and prior to 3 or after resection in early NSCLC 4. It is also a key drug in association with etoposide 5, 6 in the treatment of small cell lung cancer (SCLC), where it significantly improves survival. In mesothelioma, it has been shown to be the most active drug 7, 8.The toxicity profile of cisplatin is unique. Dose-limiting toxicity is not haematological as with cytotoxic chemotherapy, but renal with the development of acute renal failure. The administration of higher doses of cisplatin (100–120 mg·m−2) with a better therapeutic index has been made possible by mannitol-induced diuresis and hyperhydration 9. Nevertheless, the use of such dosages is associated with chronic toxicity with not only renal but also auditive neurological impairments, preventing long-term treatment as shown in a phase II randomised trial 10. In this study, conducted by the European Lung Cancer Working Party (ELCWP) in patients with advanced NSCLC, high-dose cisplatin (120 mg·m−2) was compared to moderate-dose cisplatin (60 mg·m−2) plus carboplatin (200 mg·m−2) 10. High-dose cisplatin was significantly associated with more renal (36% versus 19%), auditive (16% versus 4%) and … ER -