Treatment of Cancer with Carboplatin

Carboplatin is administered intravenously. The carboplatin is dissolved in a solution and the dosing and administration schedule are determined by the supervising oncologist. The doctor takes into account the patient’s weight, overall physical condition, known tolerance to treatment, and stage of disease. The website uptodate.com lists these are typical dosage rates:

Solid tumor (unlabeled use): 300-600 mg/m2 once every 4 weeks
Brain tumor (unlabeled use): 175 mg/m2 weekly for 4 weeks every 6 weeks, with a 2-week recovery period between courses
Ovarian cancer: 300-360 mg/m2 every 4 weeks or target AUC 5-7.5 every 3 weeks

The oncologist specifies the dose for each patient individually.

Occasionally carboplatin is injected directly into a body cavity rather than the bloodstream. For instance, intraperitoneal infusion may be employed for ovarian cancers, Regional administration more directly targets the drug to the principal tumor site and can achieve a higher drug concentration in the vicinity of the tumor. This is not a "labeled" use of carboplatin, but oncologists use it this way sometimes. According to uptodate.com, a typical regimen for intraperitoneal infusion is 200-650 mg/m2 in 2 L of dialysis fluid.

Side effects of carboplatin are like those of many chemotherapy agents. They include feelings of weakness, nausea, and hair loss. The effect on blood is similar, too: lower white blood cell count (increased risk of infection), lower red blood cell count (increased risk of anemia), and electrolyte imbalance.

Patients should make sure they get adequate nutrition (frequent small meals may help) and adequate hydration unless instructed to restrict fluid intake. Nausea and vomiting may be severe; request antiemetic. You will be susceptible to infection; avoid crowds or exposure to infection.

Occasionally, very occasionally, people have an allergic reaction to carboplatin. The symptoms are similar to allergic reactions to other materials, and if the patient is allergic, the reactions will show up on first treatment. New patients on carboplatin are monitored for allergic reaction.
And all patients are regularly monitored when on any form of chemotherapy. This monitoring include blood tests and neurologic exams to test reflexes. Some carboplatin is metabolized in the liver but mostly it passes out the kidneys unmetabolized.

Carboplatin has a half-life of about 30 hours in the body. It comes out in the urine, and it is even possible to recover the platinum from the urine.

Side effects of carboplatin.

Carboplatin is often used as part of a combination chemotherapy regimen. It is combined with one or more other chemotherapy drugs by oncologists to increase treatent efficacy.

Costs

Typically carboplatin is given at a dose about 4 times that of cisplatin because of its lower effectiveness per gram. All chemotherapy drugs, even generic ones, are expensive, and platinum-based drugs have the characteristic that their production cost depends partially on the market price of the precious metal platinum.

A British study in the early 1990s found that although carboplatin is more expensive than cisplatin on a per dose basis, the total treatment cost, including those in preventing and managing toxicity, are comparable if not lower for carboplatin.

A more recent study at Johns Hopkins University looked at cisplatin plus paclitaxel in intraperitoneal application versus carboplatin plus paclitaxel in intravenous administration.

Acquired Resistance

Alkylating agents are different from other chemotherapy agenst in how and how much resistance the body develops to them. Even with prolonged exposure, the increase in resistance is limited even after repeated treatment. Alkyklating agents are more like radiation in that respect.