Mechanism of cisplatin induced hypomagnesemia

Cisplatin is a potent and valuable platinum-based chemotherapeuritc agent used
to treat a broad spectrum of malignancies. Cisplatin can cause hypomagnesemia,
sometimes permanently and with an estimated prevalence of roughly 50%. In
recent years, the renal handling of magnesium has been largely elucidated,
especially through the identification of TRPM6, a magnesium channel. In
addition, although no single hormone for magnesium regulation has been
identified, other regulatory factors have become clear. These include 17-β-
estradiol, the endothelial growth factor, acidosis, and alkalosis. It is
important to emphasize that the serum magnesium level may not be a good
estimate of total body magnesium. Instead, a better parameter may be the
magnesium concentration in the erythrocyte. The exact mechanism of cisplatin
induced hypomagnesemia is unknown. In addition, the new insights regarding
magnesium metabolism described above have not been studied in the context of
cisplatin induced hypomagnesemia. Therefore, we intend to study cisplatin
induced hypomagnesemia in oncological patients who receive cisplatin as
monotherapy.

To study the mechanism of cisplatin induced hypomagnesemia.
To identify predisposing factors for cisplatin induced hypomagnesemia.

Prospective observational pilot study

Burden: 5-12 urine collections extra for study, 2-6 blood withdrawals extra for
study, 3-6 questionnaires extra for study (numbers depend on the exact
chemotherapy scheme).
Risk: blood withdrawal (pain, hematoma, vasovagal syncope).
Benefit: serum magnesium levels are checked frequently. If disturbed, this will
be treated, which is a potential benefit for the patients participating in the
study.