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marrow suppression + dosing by Calvert formula; gentler than cisplatin on kidneys/ears/nerves

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Carboplatin

• Class: Platinum chemotherapy (alkylating-like agent).

• Mechanism: Forms DNA crosslinks → inhibits replication and transcription → cell death.

• Indications:

  • NSCLC (often in doublets: carbo/pemetrexed, carbo/paclitaxel, carbo/gemcitabine).
  • Ovarian cancer (bread-and-butter drug).
  • SCLC, head & neck cancers, bladder, and others.

• Dosing: Calculated using Calvert formula:

  Dose (mg) = Target AUC × (GFR + 25)

  (AUC = area under curve, typically 5–7 for single-agent, 5–6 with paclitaxel).

• Clearance: Renal. Always check kidney function (GFR).

• Key Toxicities:

  • Myelosuppression: Especially thrombocytopenia (worse than cisplatin).
  • Nausea/vomiting: Moderate risk. Use antiemetics.
  • Hypersensitivity reactions: Can occur after multiple cycles.
  • Less nephrotoxicity, neurotoxicity, ototoxicity than cisplatin → chosen when cisplatin is too harsh.

• Special Notes:

  • Dose-limiting toxicity = bone marrow suppression, not kidneys like cisplatin.
  • Often paired with a second agent (pemetrexed, paclitaxel, gemcitabine).