Carboplatin

Carboplatin is a platinum-based chemotherapy drug used to treat several solid tumors. It was developed as a second-generation alternative to cisplatin, with similar anticancer activity but generally better tolerability, notably less nephrotoxicity and gastrointestinal toxicity.

Carboplatin works by entering tumor cells and forming reactive platinum complexes that crosslink DNA, thereby inhibiting replication and transcription and triggering cell death. The effectiveness depends on dose, schedule, and tumor type.

Administration is by intravenous infusion, typically every 3 to 4 weeks for several cycles. Dosing often uses the Calvert formula: Dose (mg) = target AUC × (GFR + 25). Common target AUC values range from 4 to 7 mg·min/mL, depending on regimen, with combinations such as carboplatin plus paclitaxel.

Carboplatin is primarily cleared by the kidneys; hepatic metabolism is minimal. Renal function guides dosing, and reductions are needed for impaired kidney function. Monitoring includes regular complete blood counts and renal function tests; hydration and antiemetics are used as needed.

The main dose-limiting toxicity is myelosuppression, especially thrombocytopenia and neutropenia. Nausea and vomiting are common but typically less severe than with cisplatin. Nephrotoxicity and ototoxicity are less frequent; peripheral neuropathy and electrolyte disturbances may occur. Hypersensitivity reactions can emerge after several cycles.

Carboplatin is used in ovarian cancer, non-small cell lung cancer, and several other tumors. Contraindications include severe bone marrow suppression and significant renal impairment. It is teratogenic and pregnancy should be avoided.