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.

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.

Carboplatin Information

Carboplatin
  • Other names: Paraplatin

  • Manufactured by: Bristol-Myers Squibb, Teva Pharmaceuticals, Hospira, others

  • FDA-approved: Yes (to treat ovarian, breast, pancreatic and non-small cell lung cancer)

  • Used or tested in: Lung cancer, mesothelioma, ovarian, breast and pancreatic cancer

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 are attracted only to cells that divide rapidly.

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 28 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.

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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.

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. The symptoms of kidney damage usually include pain or difficulty urinating or the appearance of blood in the urine.

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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Karen Selby, RN and Patient Advocate at The Mesothelioma Center

Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the 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.

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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