Carboplatin
Mechanism :
Carboplatin is a platinum coordination compound that is used as a cancer chemotherapeutic agent. Carboplatin, like cisplatin, produces predominantly interstrand DNA cross-links rather than DNA-protein cross-links. This effect is apparently cell-cycle nonspecific.
Indication :
- Neuroblastoma stage IV
- Neuroectodermal tumors
- Medulloblastoma
- Rhabdomyosarcoma
- Sarcoma
- Germ cell tumor
- Glioma
- Astrocytoma
- Retinoblastoma
- Wilms Tumor
- Liver tumors
Contraindications :
Carboplatin is contraindicated in patients with a history of severe allergic reactions to cisplatin or other platinum-containing compounds, or mannitol. Carboplatin should not be employed in patients with severe bone marrow depression or significant bleeding.
Dosing :
Dosage varies according to the current treatment protocol. An increasing number of protocols determine doses based on glomerular filtration rate (GFR).
Children solid tumor:
300-600 mg/m² IV once in 4 weeks.
Brain tumor:
175 mg/m² IV once a week for 4 weeks.
Adolescent:
360 mg/m² IV once in 4 weeks.
Adverse Effect :
Thrombocytopenia, leukopenia, anemia, neutropenia, nausea, vomiting, peripheral neuropathy, ototoxicity, neurotoxicity, elevated creatinine and blood urea, elevated bilirubin, alkaline phosphatase, SGOT.
Interaction :
Nephrotoxic drugs: Adverse effects increased.
Cidofovir: Combination may increase carboplatin levels, risk if toxicity; increase risk of myelosuppression.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function. |
| 10-20 | Dose as in normal renal function. |
| <10 | Dose as in normal renal function. |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unknown dialysability. Dose as in GFR<10 mL/min |
| HD | Dialysed. Dose as in GFR<10 mL/ min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
No dosage adjustments are recommended.