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Satraplatin

Clinical data
Other names	BMY 45594 BMS 182751 (OC-6-43)-bis(acetato)amminedichlorocyclohexylamine platinum(IV)
Routes of administration	Oral
ATC code	L01XA04 (WHO)
Identifiers
IUPAC name (OC-6-43)-bis(acetato)amminedichloro(cyclohexylamine)platinum
CAS Number	129580-63-8
PubChem CID	123974
UNII	8D7B37T28G
ChEBI	CHEBI:85609
CompTox Dashboard (EPA)	DTXSID00926438
Chemical and physical data
Formula	C10H22Cl2N2O4Pt
Molar mass	500.277 g/mol g·mol
(verify)

Satraplatin (INN, codenamed JM216) is a platinum-based antineoplastic agent that is under investigation as one treatment of patients with advanced prostate cancer who have failed previous chemotherapy. It has not yet received approval from the U.S. Food and Drug Administration. First mentioned in the medical literature in 1993, satraplatin is the first orally active platinum-based chemotherapeutic drug; other available platinum analogues—cisplatin, carboplatin, and oxaliplatin—must be given intravenously.

It is made available in the United States jointly by Spectrum Pharmaceuticals and GPC Biotech under the name SPERA (SatraPlatin Expanded Rapid Access).

The drug has also been used in the treatment of lung and ovarian cancers. The proposed mode of action is that the compound binds to the DNA of cancer cells rendering them incapable of dividing.

Medical Use

Satraplatin is an orally bioavailable platinum chemotherapeutic agent under development for several cancer types, including hormone-refractory prostate cancer (HRPC). Satraplatin is being developed for the treatment of men with chemorefractory HRPC for several reasons. It's relative ease of administration, potential lack of cross-resistance with other platinum agents, clinical benefits seen in early studies of HRPC, and an unmet need in this patient population after Docetaxel failure. Satraplatin may provide a palliative benefit for patients in terms of progression-free survival according to the most recent analyses of the phase III SPARC trial, and is currently under Food and Drug Administration review for this indication. Whether satraplatin and prednisone offer an advantage over docetaxel retreatment or other cytotoxic agents in this setting is under investigation.

Satraplatin has a favorable toxicity profile, and appears to have clinical activity against a variety of malignancies such as Breast Cancer, Prostate cancer and Lung cancer. The oral route of administration and the intermittent schedule makes it very convenient for clinical use. Despite this, a FDA-approved indication has not yet been achieved. The only Phase III trial with satraplatin was conducted in pre-treated metastatic prostate cancer(CRPC), revealing an improvement in progression-free survival but no overall survival benefit. 

Side Effects

Satraplatin has a number of side-effects that can limit its use:

• Anemia: Satraplatin can reduce the number of red blood cells, which carry oxygen around the body. A low red blood cell count is called anemia. This may make you feel tired and breathless. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion if the number of red blood cells becomes too low.
• Diarrhea: Satraplatin can cause diarrhea. This can usually be easily controlled with medicine, but tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have diarrhea. 
• Constipation: This can usually be helped by drinking plenty of fluids, eating more dietary fiber and doing some gentle exercise. You may need to take medicine (Laxative) to help.
• Tiredness (Fatigue): Feeling tired is a common side effect of chemotherapy especially towards the end of treatment and for some weeks after it’s over. It’s important to try to move at a comfortable pace and get as much rest as needed. Try to balance this with some gentle exercise, such as short walks, which will help. Do not drive or operate machinery if fatigue persist. 
• Nausea and vomiting: This may begin soon after the treatment is given and can last for a few days. The doctor can prescribe very effective anti-sickness (Antiemetic) drugs to prevent or greatly reduce nausea and vomiting. 
• Risk of Infection: Satraplatin can reduce the number of white blood cells, which help fight infection. White blood cells are produced by the Bone marrow. A low white blood cell count is called Neutropenia. Neutropenia can begin seven days after treatment, and  resistance to infection usually reaches its lowest point about 28 days after chemotherapy. The number of white blood cells will then increase steadily and usually return to normal before the next cycle of chemotherapy is due. 
• Bruising and bleeding: Satraplatin can reduce the production of platelets, which help the blood to clot. Having a low amount of platelets may cause unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. You may need to have a platelet transfusion if the platelet count continues to remain low. 

References

1. Wheate, Nial J.; Walker, Shonagh; Craig, Gemma E.; Oun, Rabbab (2010). "The status of platinum anticancer drugs in the clinic and in clinical trials". Dalton Transactions. 39 (35): 8113–27. doi:10.1039/C0DT00292E. PMID 20593091.
2. Kelland LR, Abel G, McKeage MJ, et al. (1993). "Preclinical antitumor evaluation of bis-acetato-ammine-dichloro-cyclohexylamine platinum(IV): an orally active platinum drug" (PDF). Cancer Res. 53 (11): 2581–6. PMID 8388318.
3. Choy H, Park C, Yao M (2008). "Current status and future prospects for satraplatin, an oral platinum analogue". Clin Cancer Res. 14 (6): 1633–8. doi:10.1158/1078-0432.CCR-07-2176. PMID 18347164.{{cite journal}}: CS1 maint: multiple names: authors list (link)
4. Satraplatin — Spectrum Pharmaceuticals
5. Choy, Hak; Park, Clinton; Yao, Min (2008). "Current Status and Future Prospects for Satraplatin, an Oral Platinum Analogue". Clin Cancer Res. 14; 1633 doi: 10.1158/1078-0432.CCR-07-2176
6.  Vaishampayan UN. (2009) "Satraplatin: Leading the new generation of oral platinum agents." Expert opinion on investigational drugs." ;18(11):10.1517/13543780903362437. doi:10.1517/13543780903362437.
7. Macmillan Cancer Support. ENgland: Registered Office 89 Albert Embankment, London, 2012.  <a href="http://www.nhs.uk/ipgmedia/national/Macmillan%20Cancer%20Support/Assets/SatraplatinMCS5pages.pdf"

• Coordination compounds
• Platinum compounds
• Acetates
• Platinum-based antineoplastic agents