Cancer carboplatin

In 21 patients with advanced non-small cell lung cancer carboplatin had no effect on the pharmacokinetics of paclitaxel 135-200 mg/m as a 24-hour intravenous infusion (58). Peripheral neuropathy occurred in 13 of 37 patients treated with paclitaxel 175 mg/m and carboplatin (59). The authors concluded that clinically important neurotoxicity increases with every cycle of chemotherapy. The peripheral neuropathy mainly affected sensory fibers without involving motor nerves. The same paclitaxeP carboplatin chemotherapy in 28 women caused no signs of acute central neurotoxicity or neuropsychological deterioration however, 11 patients had a peripheral neuropathy (60). 

Vermorken JB, ten Bokkel Huinink WW, Eisenhauer EA, Favalli G, Belpomme D, Conte PF, Kaye SB. Advanced ovarian cancer. Carboplatin versus cisplatin. Ann Oncol 1993 4(Suppl 4) 41-8. 

Bookman MA, Greer BE, Ozols RF. Optimal therapy of advanced ovarian cancer carboplatin and paclitaxel vs. cisplatin and paclitaxel (GOG 158) and an update on GOGO 182-ICON5. Int J Gynecol Cancer 2003 136 735-740. 

JP is receiving a highly myelosuppressive chemotherapy regimen for the next 3 days for his lymphoma. The chemotherapy orders specify ifosfamide, carboplatin, and etoposide. The goal of this cycle of chemotherapy is to put the cancer into remission so that his lymphoma can be cured with a bone marrow transplant. 

In patients who experienced a complete response to first-line chemotherapy and have had greater than a 6-month platinum-free interval, retreatment with a platinum-containing regimen is appropriate. Current National Comprehensive Cancer Network (NCCN) guidelines recommend the combination of carboplatin... 

Ozols RF, Bundy BN, Greer BE, et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer a gynecologic oncology group study. J Clin Oncol 2003 21 3194-3200. 

The second criteria, a different activity spectrum, is met by oxaliplatin (Figure 1.9A), the l isomer of [oxalatol f ra/rv-1,2-diaminocyclohexane)platinum (II)], oxaliplatin, [Pt(II)(oxalato)(DACH)]. This platinum agent is used for secondary treatment of metastatic colorectal cancer.77 Oxaliplatin, like carboplatin, has a kinetically slower leaving group, and is also less nephrotoxic than cisDDP. The limiting toxicity of oxaliplatin is peripheral sensory neuropathy, also seen with cisDDP. The neuropathy affects the extremities and increases in incidence and... 

Chemotherapeutic agents that have significant cancer response when combined with hyperthermia (up to 43°C) include doxorubicin, melphalan, mitomycin C (MMC), mitoxantrone, gemcitabine, etoposide, and especially the platinum-based agents carboplatin and oxaliplatin (Mohamed et al., 2003 Sugarbaker et al., 2005). Agents that do not work well with hyperthermia include irinotecan, paclitaxel, docetaxel, 5-fluorouracil, and floxuridine (Mohamed et al., 2003 Sugarbaker et al., 2005). 

Cisplatin was the first example of a platinum-based chemotherapeutic but it has been followed by others carboplatin, oxoplatin, and cycloplatam. All are variations on the original theme and all find use in the chemotherapy of cancer. 

He, Q., Liang, C.H., and Lippard, S.J. (2000) Steroid hormones induce HMGl overexpression and sensitize breast cancer cells to cisplatin and carboplatin. Proc. Natl. Acad. Sci. USA 97, 5768-5772. 

Fishman MN, Garrett CR, Simon GR, Chiappori AA, Lush RM, Dinwoodie WR, Mahany JJ, Dellaportas AM, Cantor A, Gollerki A, Cohen MB, Sullivan DM. (2006) Phase 1 study of the taxane BMS-188797 in combination with carboplatin administered every 3 weeks in patients with solid malignancies. Clin Cancer Res 12 523-528. 

Fujii M, Nameki H, Kawaura M, et al. A dose finding study of carboplatin (CBDCA) + UFT in head and neck cancer. ProcAm Soc Clin Oncol 1998 18 406a (abstr 1564). 

Early clinical studies clearly demonstrated that cisplatin could be administered safely and concurrently with radiation therapy (73-75). Early clinical trials that demonstrated the promise of the combination of cisplatin and radiation therapy included the treatment of brain tumors (76,77), head and neck tumors (78), malignant melanoma (79), and bladder cancer (80). Early clinical trial integrating carboplatin administration with radiation therapy was carried out in patients with locally advanced nonsmall cell lung cancer (NSCLC) (81). A hypothesis put forth by Coughlin and colleagues (81) was that the best clinical outcomes would be achieved with the combination of cisplatin and radiation therapy in tumors that were responsive to cisplatin. 

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