cisplatin + epinephrine

A locally administered combination of the small-molecule antineoplastic agent cisplatin and the vasoconstrictor epinephrine formulated as an intratumoral injectable gel with a bovine collagen carrier. The epinephrine-induced vasoconstriction limits systemic diffusion, enabling high intratumoral cisplatin concentrations with low plasma exposure. Mechanistically, cisplatin forms DNA intrastrand and interstrand crosslinks causing DNA damage and apoptosis, while epinephrine acts on alpha-adrenergic receptors to constrict tumor vasculature and retain drug locally. It has been evaluated primarily for palliative treatment of accessible, recurrent or refractory head and neck squamous cell carcinoma, with additional exploratory use in other solid tumors. In two randomized, double-blind, placebo-controlled phase III trials, intratumoral cisplatin/epinephrine gel produced higher objective and complete response rates versus placebo and improved tumor-related symptoms in responders. Typical gel composition per mL: cisplatin 4 mg, epinephrine 0.1 mg, purified bovine atelopeptide collagen matrix 20 mg. Reported adverse effects are predominantly local at the injection site, with minimal systemic cisplatin toxicities due to limited systemic exposure.

Brand names

IntraDose

Other names

cisplatin/epinephrine injectable gel