Chemotherapy Pill : Carboplatin
Carboplatin is a chemotherapeutic agent used to treat cancer by interfering with the growth of cancer cells. At the molecular level, carboplatin causes cancer cells to destroy themselves through the mechanism of apoptosis. Carboplatin is marketed under the brand name Paraplatin; it may also be referred to as CBDCA, JM-8, or carboplatinum.
Carboplatin is a member of the group of chemotherapy drugs known as heavy metal-like alkylating agents. Alkylating agents interfere with the genetic material (deoxyribonucleic acid, or DNA) inside the cancer
cells and prevent them from further dividing and growing more cancer cells.
Chemotherapy Pill : Purpose
Carboplatin was approved in 1989 by the Food and Drug Administration (FDA) for the palliative treatment of ovarian cancer. The term palliative means that the treatment is not intended to cure but only to relieve symptoms. Carboplatin has also been used to treat other types of cancer, including head and neck cancer, cervical cancer, lung cancer, endometrial cancer, testicular cancer, hormone-refractory prostate cancer, and
brain tumors. More recently, carboplatin has been investigated in clinical trials as a possible treatment for squamous cell skin cancers and malignant melanoma.
Chemotherapy Pill : Dosage
The dose of carboplatin can be calculated using several methods. A carboplatin dose can be determined using a mathematical calculation that measures a person’s body surface area (BSA). This number is dependent
upon a patient’s height and weight: the larger the person, the greater the body surface area. BSA is measured by the square meter (m2). The body surface area is calculated and then multiplied by the drug dosage in milligrams
per square meter (mg/m2). This calculates the actual dose a patient is to receive.
A common dosage of carboplatin alone for the treatment of patients with recurrent ovarian cancer is 360 mg/ m2 given on day one into a vein every four weeks. When given in combination with the chemotherapeutic agent cyclophosphamide for the treatment of recurrent ovarian cancer, a dose of 300 mg/m2 administered intravenously is typical. This combination is repeated every four weeks for six cycles.
The second way to determine the dose of carboplatin is for the physician to measure or estimate how well the patient’s kidneys work. The patient may be asked to collect all of their urine in a bottle for a 24-hour period. The sample will then be sent to a laboratory and analyzed. A mathematical calculation is performed to determine how well the patient’s kidneys are working and subsequently to determine the carboplatin dose.
Chemotherapy Pill : Precautions
Blood counts will be monitored regularly while on carboplatin therapy. During a certain time period after receiving carboplatin there is an increased risk of getting infections. Caution should be taken to avoid unnecessary
exposure to infectious agents. Patients should also check with their doctors before receiving live virus vaccines while on chemotherapy.
Patients who may be pregnant or trying to become pregnant should talk to their doctor before receiving carboplatin. Men and women undergoing chemotherapy are at risk of becoming sterile.
Patients with known previous allergic reactions to chemotherapy drugs should notify their doctors.
Chemotherapy Pill : Side effects
Most of the side effects of carboplatin are due to its induction of apoptosis in tumor cells. Nausea and vomiting are among the most common side effects from receiving carboplatin. Nausea and vomiting can begin up to six hours after treatment and can last as long as 24 hours. Patients are given medicines known as antiemetics before receiving carboplatin to help prevent or
decrease this side effect. Diarrhea, loss of appetite, constipation, pain, and weakness have also been reported to occur.
chemotherapy pill – Myelosuppression, or a suppression of bone marrow activity resulting in a low blood cell count, is expected to occur following carboplatin administration. When a patient’s white blood cell count drops below
normal (leukopenia), there is an increased risk of developing a fever and infections. Neupogen, a drug used to increase the white blood cell count, may be administered.
A decrease in platelet count is most notable following carboplatin administration. Platelets are blood cells that aid for the formation of clots. When the platelet count becomes abnormally low, patients are at an increased risk for bruising and bleeding. If the platelet count remains too low a platelet blood transfusion is an option. Low red blood cell counts (anemia) may also occur following many cycles of carboplatin administration; during the first cycles this is usually not a common problem. Low red blood cell counts may result in dizziness and fatigue and can be treated with the drug
A less common side effect of carboplatin is damage to nerves and nervous system tissues. Patients may feel tingling and numbness of the fingers and toes. This side effect is more common in patients over 65 years of age or those who have previously received the chemotherapy drug cisplatin.
Other less common side effects include rash, itching, hair loss (alopecia), mouth sores, hearing problems, kidney problems, liver problems, vision problems, swelling, redness and pain at the site of injection, allergic reactions, heart problems, and breathing problems.
Carboplatin may cause the body to waste certain normal electrolytes that circulate in the body. Low levels of magnesium, calcium, phosphate, or sodium can be found in patients who have received carboplatin. These
rarely cause difficulties and are monitored by the doctor.
Some patients develop hypersensitivity or allergic reactions to carboplatin that may include difficulty breathing, rash, itching, redness in the face, dizziness, an increased heart rate, and a drop in blood pressure. The risk of such reactions is increased in patients who have had more than six cycles of treatment with the drug. A group of researchers in Ohio has developed a skin test to evaluate patients for possible hypersensitivity reactions to carboplatin, and a second team is working on a desensitization regimen that will allow patients who have become hypersensitive to the drug to continue to benefit from treatment with it.
Chemotherapy Pill : Interactions
Patients being treated with carboplatin should avoid other drugs that may cause damage to the kidneys or hearing.