Carboplatin, sometimes known as paraplatin, is a platinum-based chemotherapy drug used to treat a number of cancers, including malignant pleural mesothelioma. Although carboplatin has been on the market since the late 1980s, it has not received FDA approval for mesothelioma treatment. However, the drug has been approved by the FDA to treat other cancers, including advanced ovarian cancer and breast cancer.
Carboplatin is a derivative of cisplatin, another platinum-based chemotherapy drug, but is less harsh and causes fewer side effects. As a result, cancer patients are often able to tolerate the therapy better and experience an improved quality of life. In mesothelioma patients, carboplatin is given as a substitute to cisplatin and is sometimes combined with other cancer drugs like Alimta.
How Carboplatin Is Used to Treat Mesothelioma
Mesothelioma patients are typically given a combination of carboplatin and Alimta, also known as pemetrexed, through an IV, to help slow down the spread of cancer. It takes about 60 minutes to give a patient an intravenous carboplatin treatment and is repeated every 21 days, depending on the patient’s individual case and treatment needs. Factors that may determine the dosage of carboplatin include a patient’s general health, cancer stage, age and how they respond to the treatment cycles.
A carboplatin and pemetrexed combination therapy may be offered as a first-line chemotherapy option for patients with advanced stage pleural mesothelioma. One study suggested that carboplatin combined with pemetrexed could extend survival longer than the combination of cisplatin and pemetrexed. Patients who received cisplatin and pemetrexed had a median survival of 14.9 months, while those given carboplatin and pemetrexed survived 15.7 months.
Additionally, unlike cisplatin, which tends to be harsher on a person’s body, carboplatin stays in the body longer and poses fewer health risks and side effects. Patients who undergo chemotherapy using carboplatin and pemetrexed will be given folic acid tablets, oral steroids and an injection of Vitamin B12 to further reduce side effects.
Possible Side Effects of Carboplatin
Carboplatin, much like cisplatin, has a variety of side effects associated with it, but they tend to be less severe due to the drug’s composition. A doctor will perform blood tests to determine if dosage should change or stop and to monitor kidney function throughout the process.
Like most anti-cancer drugs, common side effects stemming from carboplatin use may include pain, nausea, hair loss or thinning, mouth sores, sore throat and swelling or redness near or at the injection site. Less common side effects like fainting, loss of vision, trouble breathing, hearing loss and decreased urination should be brought up to a doctor immediately to prevent further damage or other adverse effects. Carboplatin may also cause several other severe side effects in rare cases.
- Allergic reactions, typically within a few minutes after the infusion is given
- Decrease in bone marrow blood cells, which results in an increased chance of infection or bleeding and the possible need for a blood transfusion
- If the patient is pregnant, carboplatin may cause damage to the fetus. Women should also not breastfeed while receiving the drug because it could transfer into their breast milk
- Increased chance of developing another cancer
- Peripheral neuropathy, which causes a tingly feeling in a patient’s hands and feet
Patients undergoing chemotherapy with carboplatin may suffer from lower red blood cell and white blood cell counts, and will have to take extra precautions to avoid getting sick. In most cases, symptoms caused by carboplatin will subside once the cancer treatment ends.
Studies Associated with Carboplatin
Numerous clinical trials over the years have proven that carboplatin can serve as a suitable replacement for cisplatin in patients with mesothelioma who are unable to tolerate its side effects. According to the American Society of Clinical Oncology, several phase 1 and phase 2 studies using a combination of pemetrexed and carboplatin showed similar results as a phase 3 study using pemetrexed and cisplatin, the parent drug of carboplatin. Patients who received the combination of carboplatin and pemetrexed had a median survival of 13 – 14 months, with about 7 – 8 months progression-free. In comparison, pemetrexed and cisplatin have showed varied survival times in different studies, with many noting survival around 12 – 16 months.
A phase 2 study evaluated the efficacy of carboplatin and pemetrexed as a first-line treatment for unresectable pleural mesothelioma. Of the 62 patients treated, 55% achieved stable disease, meaning there was no spreading or growth of tumors. An additional 29% of patients saw a partial response to the treatment. Researchers noted an average overall survival of 14 months, with a median seven months before disease progression. The cell type was a big factor in varied life expectancy, with epithelial patients surviving 16 months and sarcomatoid mesothelioma patients surviving 11 months on average.
Carboplatin has also been combined with other drugs, notably Caelyx and gemcitabine (referred to as CCG) as a third-line treatment in patients with advanced pleural mesothelioma. In one clinical trial, the patients received the standard of care (pemetrexed and a platinum-based drug) first, then received a second-line treatment of vinorelbine before receiving the carboplatin combination. Patients in the study survived more than 25 months from diagnosis and had a progression-free survival of 4.1 months. Overall, those who underwent the CCG treatment saw a disease control rate of 60%.
Author: Linda Molinari
Editor in Chief, Mesothelioma Cancer AllianceRead about Linda
Reviewer: Annette Charlevois
Patient Support CoordinatorRead about Annette
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