Figure 1. Factors influencing short‐ and long‐term effects of cisplatin.

Overview of how different factors can influence long‐term normal tissue effects after cisplatin (CDDP) treatment. CDDP causes DNA damage. Many cellular effects are mediated by p53 as part of the DNA damage response yielding long‐term side effects. Factors such as tissue differences (metabolism, pharmacokinetics, proliferative status, and DNA damage response) and systemic differences (nutritional status, hormones, immunological effects, age, ethnicity, etc.) influence these side effects, which resemble accelerated aging (ototoxicity, neurotoxicity, and nephrotoxicity) and/or increase cancer (secondary malignancies). p53 inhibition using PFT‐α and likely dietary restriction might reduce at least part of these side effects.