What Is Carboplatin?
Carboplatin (marketed under the brand name Paraplatin®) was originally manufactured by Bristol-Myers Squibb, an American pharmaceutical company founded in 1858 by Edward Robinson Squibb. Today, however, several companies (like Hospira and Teva Pharmaceuticals) manufacture generic carboplatin. Originally, the medication was first developed and patented in the 1970s and approved by the Food and Drug Administration (FDA) in 1986. The drug has similar properties to standard chemotherapy drug cisplatin and serves as an alternative option to it.
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Carboplatin treats multiple forms of cancer, including:
- Germ cell tumors
- Head and neck
- Osteogenic sarcoma
The drug may also be used in preparation for a stem cell or bone marrow transplant, often called “conditioning.” Depending on the diagnosis, conditioning includes high doses of chemotherapy to eliminate the cancer or to make space in the bone marrow for new cells to grow.
Chemotherapy for Mesothelioma Treatment
Mesothelioma patients often rely on a combination of standard treatment drugs, including chemotherapy, to eliminate cancer cells and prevent them from metastasizing (i.e., spreading) throughout the body.
Carboplatin is not currently approved by the FDA to treat mesothelioma, but patients may receive it as a treatment in clinical studies. The National Comprehensive Cancer Network (NCCN) recommends the medication as a treatment when combined with other chemotherapy drugs.
So far, clinical trials with pleural mesothelioma patients receiving carboplatin in combination with standard chemotherapy drug pemetrexed (Altima®) have shown effectiveness. Typically, treatment involves giving patients specific combinations of drugs based on how they tolerate each drug separately.
How Carboplatin Works
Like healthy cells, cancer cells spread by replicating and dividing (known as mitosis). Carboplatin works by slowing cell division so that mesothelioma cells don’t spread, or forces them to spread slower. Receiving carboplatin, however, also slows the division of healthy cells, which often leads to a variety of side effects.
Most chemotherapy medications are effective at killing cells that divide rapidly. Carboplatin, however, is an alkylating agent that works best when cells are in the resting phase of cell division. Carboplatin works by damaging the RNA and/or DNA inside cells that aid in replication and division. Both healthy and cancerous cells die when they are unable to divide, causing the tumor to shrink. The medication is given to each patient at a specific time based on the rate at which the cells divide.
Carboplatin is given through intravenous infusion (IV) or directly into the peritoneal cavity in the abdomen. Administration of the drug typically takes between 15 and 60 minutes for each dose. The amount received depends on several factors, including the patient’s weight, height, overall health, preexisting health problems, and how their body responds to treatment. Typically, patients receive the drug at a hospital or treatment center; it is given every 21 days.
Side Effects of Carboplatin
Since chemotherapy does not know the difference between healthy and cancerous cells, side effects can occur. Blood cells, cells in the mouth, stomach, and bowel, and hair follicles are typically affected most by chemotherapy. As a result, common side effects of carboplatin include hair loss, changes to the ability to taste, vomiting, weakness, nausea, and low red and white blood cell counts.
Cancer patients typically tolerate carboplatin better than cisplatin and experience fewer side effects. However, taking carboplatin can come with serious risks, including anemia, bleeding, and infections. Most patients do not experience all of the listed side effects. Most side effects are predictable in regards to their onset and duration. While side effects typically go away once treatment is complete, doctors may prescribe other medications to help minimize or prevent them.
Less common side effects of carboplatin occurring in fewer than 30 percent of patients include:
- Abdominal pain
- Abnormal blood electrolyte levels
- Abnormal blood liver enzymes
- Burning sensation at the injection site
- Visual changes
- Ringing in the ears
- Hearing loss
- Mouth sores.
- Peripheral neuropathy (numbness and tingling of the extremities)
- Shortness of breath
Carboplatin may present similar allergic reactions in patients who received cisplatin and experienced reactions. To prevent the risk of infection, avoid people with colds, wash your hands, and drink two to three quarts of fluid every 24 hours. Additionally, it is important to report fever or signs of infection to your health care provider as soon as they appear. Cancer patients receiving carboplatin may also benefit from getting plenty of rest and maintaining good nutrition.
Carboplatin in Clinical Trials
Several clinical trials have tested the effectiveness of carboplatin as a chemotherapy treatment for mesothelioma. Research generally shows extended survival time and reduced symptoms such as difficulty breathing and chest pain.
The combination of carboplatin and chemotherapy drug gemcitabine investigated effectiveness on pleural mesothelioma patients in a Phase II trial in 2003. Results found improvement in pain reduction in over a quarter of the patients and breathing improvement in nearly half of the participants. Importantly, around 25 percent of patients experienced tumor reduction.
In 2006, a Phase II trial tested carboplatin in combination with pemetrexed in pleural mesothelioma patients. Researchers found similar results to previous studies combining standard chemotherapy drug cisplatin and pemetrexed. The overall reported survival time in the study was 12.7 months. A 2008 trial compared the two different combinations (carboplatin versus cisplatin in combination with pemetrexed) and found cisplatin and pemetrexed had a higher response rate of 26.3 percent compared to 21.7 percent in participants receiving carboplatin and pemetrexed. Other variables were similar, including a one-year survival time.
Talk to Your Doctor
Before starting carboplatin treatment, talk to your doctor about any medications you are taking, including prescription, over-the-counter medicines, vitamins, and herbal remedies. Doctors typically do not permit taking products containing aspirin, as it could affect the carboplatin’s effectiveness. To learn more about mesothelioma treatment, download our free mesothelioma guide.
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