Eloxatin
How it works
Forms platinum-DNA adducts causing interstrand crosslinks. Used in mFFX for mPDAC.
Oxaliplatin's cold sensitivity is the most distinctive toxicity. Patients must avoid cold exposure for 3–5 days post-dose. Dose-limiting sensory neurotoxicity typically emerges at cumulative 780–850 mg/m² (~9–10 cycles); symptoms between cycles persist beyond ~1000 mg/m² cumulative. Stop-and-go strategy per eviQ 1512.
Dosing
Typical doses
- 85 mg/m² IV
Schedule
- Day 1 of 14-day mFFX cyclecycle_linked
Side Effects
- •Acute cold dysaesthesia (triggered by cold exposure) — 3–5 days post-dose
- •Chronic cold sensitivity (paresthesia in hands/feet)
- •Nausea, vomiting
- •Fatigue
- •Myelosuppression (mild compared to gemcitabine)
- Anaphylaxis / hypersensitivity (especially after multiple cycles)
- Sensory neuropathy (cumulative) — can be severe and irreversible
- Acute kidney injury (rare, usually reversible with hydration)
Monitoring
- Neuropathy grade (CTCAE) — critical for mFFX continuation
- Premedication with dexamethasone + 5-HT3 blocker + H2 blocker for first dose
- FBC, U&Es, LFTs
Diet & Food Interactions
Cold foods, cold drinks, cold air on skin
Triggers acute dysaesthesia — throat spasm, jaw pain, dysphagia (swallowing difficulty)