Carboplatin
Indications
Carboplatin is used for:
Ovarian carcinoma, Lung cancer
Adult Dose
Intravenous
Small cell lung cancer; Advanced ovarian carcinoma
Adult: IV As single agent in treatment-naive patients: 400 mg/m2;
As single agent in previously treated patients: 360 mg/m2; W/ cyclophosphamide in treatment-naive patients: 300 mg/m2.
Doses to be given not more frequently than every 4 wk. Adjust subsequent doses based on nadir of WBC and platelet counts.
Hepatic Impairment
Dose adjustment may not be necessary; not studied
Child Dose
Solid tumor
300-600 mg/m² IV q4Weeks
Sarcoma (bone/soft tissue)
400 mg/m²/day for 2 days every 21 days
Brain tumor
175 mg/m² qWeek x 4 weeks with a 2 weeks recovery period between courses
Bone marrow transplant preparative regimen
500 mg/m²/day x 3 days
Retinoblastoma
1-2 mL subconjunctival injection of 10 mg/mL solution per dose
Renal Dose
Renal impairment:
CrCl (ml/min)
>40 Recommended dose: 400 mg/m2.
20-39 Recommended dose: 250 mg/m2.
Administration
IV Preparation
Single-dose lyophilized powder (reconstitution require)
Reconstitute powder with sterile water for injection, D5W, or 0.9% NaCl to yield a final concentration of 10 mg/mL
Can be further diluted to concentrations as low as 0.5 mg/mL with D5W or 0.9% NaCl
Multidose premixed injectable solution
Available as a 10 mg/mL aqueous solution
Can be further diluted to concentrations as low as 0.5 mg/mL with D5W or 0.9% NaCl
IV Administration
Administer IV over 15 min or continuous IV infusion over 24 hr
May also be administered intraperitoneally
When administered as sequential infusions, taxane derivatives (docetaxel, paclitaxel) should be administered before platinum derivatives to limit myelosuppression and to enhance efficacy
Do not use aluminum-containing needles or IV administration sets that may come in contact with carboplatin (aluminum can cause precipitate formation and loss of potency)
Contra Indications
Previous allergy; pregnancy, lactation; allergy to other platinum compounds; severe bone marrow depression; significant bleeding, aluminium containing needles and IV sets.
Precautions
Neonates; diminished renal function; neurotoxicity; liver function impairment.
Lactation: not known if excreted in breast milk; do not nurse
Pregnancy-Lactation
Pregnancy Category: D
Lactation: not known if excreted in breast milk; do not nurse
Interactions
Increased risk of ototoxicity when used with aminoglycosides.
Adverse Effects
Side effects of Carboplatin :
>10%
Leukopenia (26-97%), Neutropenia (21-96%), Nausea (81-93%), Vomiting (81-93%), Anemia (14-90%), Magnesium loss (43-61%), Thrombocytopenia (33-66%), Alopecia (2-49%), Asthenia (11-41%), Elevated alkaline phosphatase (29-37%), Central neurotoxicity (5-26%), Elevated AST (19-20%), Peripheral neuropathy (6-15%)
1-10%
Immune hypersensitivity reaction (2-9.2%), Elevated bilirubin (5%)
Frequency Not Defined
Visual disturbance (rare)
Potentially Fatal: Bone marrow suppression and anaphylactic reactions.
Mechanism of Action
Carboplatin is an alkylating agent which binds covalently to DNA. It modifies the cell cycle by interfering with DNA structure and function.