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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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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).
Bone marrow suppression, anemia, vomiting, anaphylactic-like reactions, fetal toxicity
Carboplatin in 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 should be used with caution in individuals with kidney disease because of risks of worsening kidney function and increased risk of carboplatin toxicity.
Like most chemotherapy drugs, carboplatin is harmful to unborn babies. Thus, women who are pregnant or breastfeeding should not use it.
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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 cancer 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.
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 16.5 months. A quarter of patients saw their tumors shrink in half. Nearly half of the participants reported improvement in breathing difficulty, 40% improved in weight and 26% 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 results similar 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% compared to the 21.7% response rate of carboplatin and pemetrexed, all other measures were similar. For example, one-year survival rates were 63% for the cisplatin group and 64% for 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 tolerate or cannot receive 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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