Carboplatin

Palliative treatment of patients with ovarian carcinoma recurrent after prior chemotherapy, including patients who have been previously treated with cisplatin. Also used in combination regimens for small cell and non-small cell lung cancer, bladder cancer, head and neck cancer, and other solid tumors.

Ovarian cancer: 360 mg/m² IV on Day 1 every 4 weeks (single agent) or AUC-based dosing using the Calvert formula: Total Dose (mg) = Target AUC × (GFR + 25). Target AUC typically 4–6 mg/mL·min for combination therapy, 4–6 for single agent. Cycle frequency: every 3–4 weeks. Do not repeat doses until neutrophils ≥2,000/mm³ and platelets ≥100,000/mm³.

Injection: 50 mg/5 mL (10 mg/mL), 150 mg/15 mL (10 mg/mL), 450 mg/45 mL (10 mg/mL), 600 mg/60 mL (10 mg/mL) — aqueous solution for IV infusion

Severe hypersensitivity to carboplatin or other platinum-containing compounds. Severe bone marrow depression.

• Myelosuppression: Dose-limiting toxicity. Severe thrombocytopenia, leukopenia, and anemia. Monitor CBC before each cycle and between doses.
• Hypersensitivity Reactions: Severe allergic reactions including anaphylaxis have occurred. Epinephrine, corticosteroids, and antihistamines should be available.
• Nephrotoxicity: Less nephrotoxic than cisplatin but renal function must be monitored. Dose adjustments required for renal impairment.
• Peripheral Neuropathy: Cumulative, dose-dependent peripheral neuropathy reported.
• Ototoxicity: Hearing loss reported, particularly in pediatric patients.
• Vomiting: Moderate to severe emetogenicity. Premedicate with antiemetics.
• Embryo-Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential to use effective contraception.

Thrombocytopenia (62%), Anemia (71%), Leukopenia (85%), Nausea/Vomiting (65%), Nephrotoxicity (10%), Peripheral Neuropathy (15%)

Consult the complete prescribing information for a comprehensive list of adverse reactions and their frequencies.

Nephrotoxic drugs (aminoglycosides, amphotericin B): Additive nephrotoxicity — use with caution.
Myelosuppressive agents: Enhanced bone marrow suppression.
Phenytoin: Carboplatin may reduce phenytoin levels; monitor.
Warfarin: Enhanced anticoagulant effects reported; monitor INR.

Can cause fetal harm. Advise females of reproductive potential to use effective contraception. Consult the full prescribing information for pregnancy risk details.

Advise women not to breastfeed during treatment and for a period after the last dose. Refer to prescribing information for duration guidance.

Safety and effectiveness in pediatric patients have not been established unless otherwise noted in the full prescribing information.

Dose modifications for organ impairment are specified in the complete prescribing information.

Carboplatin is a platinum coordination compound that produces predominantly interstrand DNA cross-links, inhibiting DNA synthesis and function. It acts as an alkylating agent, forming reactive platinum complexes that bind to DNA, causing strand breaks and preventing replication and transcription.

Protein binding: Low initial binding that increases to irreversible platinum binding over time. Renal elimination: >90% of platinum excreted in urine within 24 hours. Half-life (free platinum): ~1.1–2 hours. Half-life (total platinum): ~6 hours. GFR-based dosing (Calvert formula) accounts for individual variation in clearance.

Clinical efficacy and safety data supporting the approval are available in the full prescribing information and from the clinical trials listed below.

• ICON3 — Carboplatin vs CAP or cisplatin-paclitaxel in advanced ovarian cancer. Phase III, n=2074.
  🔬 NCT00002574 ↗📄 Primary Publication ↗
• SWOG-9509 / GOG-186 — Carboplatin + paclitaxel vs cisplatin + paclitaxel in advanced ovarian cancer. Phase III, n=792.
  📄 Primary Publication ↗

Carboplatin has FDA-approved indications across the following cancer types covered on CancerDrugEvidence: