Karboplatin

Karboplatin, also spelled carboplatin, is a platinum-based chemotherapy drug used to treat various cancers. It is a second-generation platinum compound and a close analog of cisplatin, designed to retain anticancer activity while reducing some of cisplatin’s toxicities. The active species forms after aquation and creates DNA crosslinks that interfere with replication and transcription, leading to cancer cell death.

Clinical use of karboplatin is broad but it is commonly employed in the treatment of ovarian cancer, often in combination with paclitaxel as first-line therapy. It is also used for non-small cell lung cancer, head and neck cancers, cervical cancer, and other solid tumors. Dosing is typically calculated from the area under the concentration–time curve (AUC) using the Calvert formula: Dose (mg) = AUC × (GFR + 25). Regimens are usually given every three to four weeks, with adjustments for renal function and tolerance.

Adverse effects are dominated by myelosuppression, particularly thrombocytopenia and neutropenia. Nausea and vomiting can occur, though karboplatin is generally less nephrotoxic and ototoxic than cisplatin. Peripheral neuropathy and hearing loss are less common but can occur, and hypersensitivity reactions may develop after repeated courses. Dose modifications are often required for impaired renal function, and patients require regular blood count monitoring.

Pharmacologically, karboplatin binds DNA to form crosslinks that block replication and transcription, promoting cancer cell death. Its toxicity profile and dosing approach distinguish it from cisplatin, making it a preferred option in many regimens where nephrotoxicity or hearing loss is a major concern.