Carboplatin prediction

The use of weekly paclitaxel (45 mg/m2) and carboplatin (100 mg/m2) has been reported (135,136). This combination as used to treat 62 patients with stage III and IV squamous cell carcinoma of the head and neck concurrently with radical radiotherapy lead to a clinical complete response rate of 75 % both at the primary and in the neck with a median survival of 33 mo (135). The authors report a retrospective comparison to similar patients treated with concurrent carboplatin alone or concurrent carboplatin and bleomycin and show on multivariate analysis that complete response and treatment with paclitaxel were predictive for survival (136). This result while encouraging is retrospective in nature and is subject to potential bias. 

The present drug of choice for this purpose is cis-platin [cis-diamminedichloroplatinum (II)], or its analog carboplatin. As will be discussed in Chapter 30, early compartmental models predicted a substantial pharmacokinetic advantage of intraperitoneal over intravenous delivery (8). A later Phase III trial (7) confirmed that a comparative survival advantage... 

Zanotti K, Rybicki L, Kennedy A, et al. Carboplatin skin testing A skintesting protocol for predicting hypersensitivity to carboplatin chemotherapy. J Clin Oncol 2001 19 3126-3129. 

Benezet, S., Guimbaud, R., Catelut, E., Chevreau, C., Bugat, R., and Canal, P. How to predict carboplatin clearance from standard morphological and biological characteristics in obese patients. Annals of Oncology 1997 6 607-609. 

Chatelut, E., Canal, R, Brunner, V., Chevreau, C., Pujol, A., Boneu, A., Roche, H., Houin, G. and Bugat, R., Prediction of carboplatin clearance from standard morpho-logical and biological patient characteristics, /. Natl. Cancer Inst., 87(8), 573, 1995. 

Chatelut E et al. Prediction of carboplatin clearance from standard morphological and biological patient characteristics. J Natl Cancer Inst 1995 87 573-580. 

---