Carboplatin

Doctors prescribe the chemotherapy drug carboplatin to treat a variety of cancers, including mesothelioma as a second-line treatment. It is more physically tolerable than stronger chemotherapy drugs, such as cisplatin, and it results in less severe side effects.

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This page features: 11 cited research articles

Introduced in the late 1980s, this cancer drug is favored by many physicians because its side effects are much less severe than many other chemotherapeutic drugs, particularly cisplatin, which is the “parent” drug of carboplatin (meaning that carboplatin is a modified form of cisplatin).

Carboplatin is most commonly used to treat ovarian, lung, head and neck cancers, but it has also shown some success in treating mesothelioma.

Chemotherapeutic drugs are designed to kill cancer cells. Carboplatin works by breaching the cellular wall and binding to the cell’s DNA, preventing the cell from dividing and functioning normally, which eventually kills the cell. These drugs target cancer cells because they mostly affect cells that divide rapidly.

Unlike other chemotherapy drugs, carboplatin is dosed based on projected total body exposure, using a calculated measurement called “area under the curve” (AUC).

Mesothelioma Treatment

Carboplatin chemotherapy is typically administered on an out-patient basis at a hospital or treatment center. The medication is given intravenously, usually once every 21 days. In cases where a patient with mesothelioma requires more frequent chemotherapy, or where carboplatin treatment is combined with other treatments or drugs, it may be administered on an in-patient basis, requiring a stay of two or more consecutive days in the hospital.

Carboplatin Information
Name Paraplatin
Alternate Names Carboplatin, Carboplatinum
Manufacturer Pfizer
Dosage AUC 5 every three weeks
Administration Route Intravenous
Active Ingredient Carboplatin
Drug Class Antineoplastic alkylating agent
Medical Code J9045
Interacting Drug Docetaxel, paclitaxel, aminoglycoside antibiotics, leflunomide, natalizumab, pimecrolimus, topotecan, trastuzumab
Related Drug Bone marrow suppression, anemia, vomiting, anaphylactic-like reactions, fetal toxicity
Medical Studies Study of Nivolumab Combined with Ipilimumab Versus Pemetrexed and Cisplatin or Carboplatin as First Line Therapy in Unrescetable Pleural Mesothelioma Patients (CheckMate743)
FDA Warning Bone marrow suppression, anemia, vomiting, anaphylactic-like reactions, fetal toxicity

Anyone with kidney disease is discouraged from seeking treatment with carboplatin. It should be noted that the drug, like most chemotherapy drugs, is harmful to unborn babies. Thus, women who are pregnant or breastfeeding should not use it.

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Side Effects

Side effects of carboplatin are typically less severe than those associated with most other chemotherapeutic agents.

However, patients taking this medication can still expect to experience some unpleasant side effects, which may include:

  • Hair loss
  • Impaired immune function
  • Nausea and vomiting
  • Fatigue
  • Loss of appetite
  • Constipation
  • Stomach pain
  • Impaired vision or hearing
  • Feelings of fatigue or weakness
  • Increased tendency for bruising or bleeding (due to poor clotting)

Patients experiencing the following should immediately call their doctor:

  • Red urine
  • Dizziness or feeling of faintness
  • Black, tarry stools
  • Fever
  • Chills
  • Shortness of breath or wheezing
  • Swelling of the feet or ankles
  • Rash

Those treated with carboplatin for mesothelioma typically experience reduced immune system function and become more prone to infection. This means even a cold may be dangerous to a patient receiving this treatment. Anyone receiving treatment with carboplatin should avoid contact with people who have colds or other infections.

A potentially serious side effect is kidney damage. Your doctor will be monitoring for this.

The appearance of any side effects, whether mild or serious, should be discussed with a doctor as soon as they arise. A cancer doctor may be able to prescribe medication to help alleviate certain side effects such as nausea, vomiting, and loss of appetite. To avoid potential life-threatening complications, anyone who is taking carboplatin should seek medical advice if they contract any kind of infection or experience fever, chills, rash or sore throat.

Studies

Research shows that carboplatin is an effective form of chemotherapy for mesothelioma that extends survival and reduces symptoms including difficulty breathing and chest pain.

In 2003, a Phase II clinical trial investigated the combination of carboplatin and gemcitabine in pleural mesothelioma patients and reported significant improvement of symptoms along with a significant median survival time of 66 weeks (approximately 16 months). A quarter of patients saw their tumors shrink in half. Nearly half of the participants reported improvement in breathing difficulty, 40 percent improved in weight and 26 percent reported pain reduction.

A 2006 Phase II trial of carboplatin and pemetrexed in pleural mesothelioma patients reported an overall survival of 12.7 months. Researchers noted that this chemotherapeutic combination produced similar results to the FDA-approved combination of cisplatin and pemetrexed, but with fewer side effects.

A 2008 Phase III trial compared the effects of carboplatin versus cisplatin in combination with pemetrexed among pleural mesothelioma patients. While cisplatin and pemetrexed had a higher response rate of 26.3 percent compared to the 21.7 percent response rate of carboplatin and pemetrexed, all other measures were similar. For example, one-year survival rates were 63 percent for the cisplatin group and 64 percent for the carboplatin group.

In 2014, a retrospective study compared carboplatin with mitomycin as a HIPEC drug for peritoneal mesothelioma. One- and five-year survival rates among the carboplatin group were 89.7 percent and 62.5 percent, respectively. These numbers far outshined the mitomycin group, which displayed one- and five-year survival rates of 72.3 percent and 27.3 percent, respectively. Researchers also reported significantly shorter hospital stays among the carboplatin group.

While carboplatin may not be the first drug of choice for mesothelioma, it is an effective one that is well suited for those who don’t respond well to cisplatin. The response rates and survival rates are comparable to cisplatin, with the added benefit of causing less severe side effects.

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Last Modified September 24, 2018

Registered Nurse and Patient Advocate

Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the regional director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections. She is also a member of the Academy of Oncology Nurse & Patient Navigators.

Walter Pacheco, Managing Editor at Asbestos.com
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7 Cited Article Sources

  1. Cancer Research UK. (2016, July 4). Carboplatin. Retrieved from: http://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/drugs/carboplatin
  2. National Cancer Institute. (2015, December 10). Carboplatin. Retrieved from: https://www.cancer.gov/about-cancer/treatment/drugs/carboplatin
  3. Chemocare. (2017). Carboplatin. Retrieved from: http://chemocare.com/chemotherapy/drug-info/carboplatin.aspx
  4. Ceresoli, G., et al. (2006). Phase II study of pemetrexed plus carboplatin in malignant pleural mesothelioma. Journal of Clinical Oncology; 24(9):1443-1448. doi: 10.1200/JCO.2005.04.3190
  5. Santoro, A., et al. (2008). Pemetrexed plus cisplatin or pemetrexed plus carboplatin for chemonaïve patients with malignant pleural mesothelioma: results of the International Expanded Access Program. Journal of Thoracic Oncology; 3(7):756-763. doi: 10.1097/JTO.0b013e31817c73d6
  6. Favaretto, A., et al. (2003). Gemcitabine combined with carboplatin in patients with malignant pleural mesothelioma: a multicentric phase II study. Cancer; 97(11):2791-2797. doi: 10.1002/cncr.11405
  7. Shetty, S., et al. (2014). Comparison of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with mitomycin or carboplatin for diffuse malignant peritoneal mesothelioma. The American Surgeon; 80(4):349-352. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/24887664
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