II. Indications (Part of combination protocols)

  1. FDA approved
    1. Ovarian Cancer
  2. Off-Label Use
    1. Adenocarcinoma (unknown primary)
    2. Bladder Cancer
    3. Breast Cancer
    4. Cervical Cancer
    5. Endometrial Cancer (advanced)
    6. Head and neck squamous cell cancer
    7. Leukemia (Acute)
    8. Lung Cancer (squamous cell, non-small cell and small cell)
    9. Lymphoma (Hodgkin or Non-Hodgkin)
    10. Melanoma
    11. Mesothelioma
    12. Neuroendocrine Tumors
    13. Prostate Cancer
    14. Sarcoma
    15. Testicular Cancer (Germ Cell)

III. Mechanism

  1. Second-generation platinum based Antineoplastic Agent
    1. More stable and less toxic than its parent drug Cisplatin
  2. Components
    1. Platinum atom
    2. Ammonia groups (2)
    3. Cyclobutane-dicarboxyl residue
  3. Activated intracellularly as reactive platinum complexes
    1. Binds DNA (e.g. GC rich regions)
    2. Results in DNA cross-links
    3. Results in cell growth inhibition, apoptosis and cell death

IV. Medications

  1. Carboplatin IV Solution (10 mg/ml) in 5 ml, 15 ml, 45 ml and 60 ml vials

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Alopecia
  2. Bone Marror Suppression (esp. with comorbid Renal Insufficiency)
  3. Hepatotoxicity with increased Liver Function Tests
  4. Nephrotoxicity
  5. Peripheral Neuropathy
  6. Secondary Malignancy
  7. Vomiting

VII. Safety

  1. Avoid in Lactation
  2. Pregnancy Category D
    1. Avoid in Pregnancy (all trimesters)
    2. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Renal Function tests
    3. Liver Function Tests

VIII. Drug Interactions

  1. Decreases Phenytoin levels

IX. Efficacy

  1. Similar efficacy as Cisplatin for Lung Cancer and Ovarian Cancer
  2. Decreased efficacy compared with Cisplatin for germ cell tumors, Bladder Cancer, head and neck cancer

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