Carboplatin

What Is Carboplatin?

Carboplatin is a chemotherapy drug often sold under the brand name Paraplatin and Paraplatin NovaPlus. Carboplatin, a derivative of cisplatin, was discovered in the 1970s by two scientists who were tasked with creating a new chemotherapy drug with the same benefits of cisplatin but less side effects.

The U.S. Food and Drug Administration approved the drug in 1989. More than five decades after its creation, carboplatin remains one of the most effective chemotherapy drugs and is valued for being less toxic than cisplatin.

Oncologists mainly use carboplatin to treat ovarian cancer. However, they also use carboplatin to treat different types of cancer, including mesothelioma and lung cancer.

How Is Carboplatin Administered?

Carboplatin is typically administered by an intravenous (IV) injection into the bloodstream through a drip in the arm or hand.

In some cases, carboplatin chemo is used for hyperthermic intraperitoneal chemotherapy (HIPEC). HIPEC is a cancer treatment in which a patient’s organs are bathed in heated chemotherapy to kill microscopic cells left behind after mesothelioma surgery.

A procedure known as cytoreduction surgery with HIPEC is used to treat patients with peritoneal mesothelioma.

The treatment cycle for carboplatin is usually 21 days. In most cases, the drug is administered for about an hour on the day of treatment, with no additional chemotherapy for the next 20 days.

At the end of the cycle, a new cycle may begin that once again involves a single dose of carboplatin for the duration of the treatment cycle.

How Does Carboplatin Treat Mesothelioma?

Carboplatin treats mesothelioma by attacking cancer cells at a genetic level. Mesothelioma occurs when cancer cells multiply throughout the body. Carboplatin attempts to interfere with that multiplication by altering the cells’ DNA.

Cellular DNA is comprised of two individual DNA strands that tell a cell how to behave and multiply. Many anticancer agents work by damaging each of those individual DNA strands, which the cells then have to repair.

Unfortunately, carboplatin doesn’t only attack cancer cells. Because it seeks out cells that reproduce quickly, it’s notorious for damaging healthy red blood cells and white blood cells. The good news is that these cells typically return to their regular levels 28 days after a patient receives carboplatin.

Carboplatin Drug Combinations

Carboplatin is most commonly combined with pemetrexed, which is known by its brand name Alimta.

Carboplatin and pemetrexed have been proven to be more effective in fighting mesothelioma than either drug alone. Carboplatin’s platinum base essentially super boosts the positive effects of pemetrexed.

Studies have suggested that carboplatin be used instead of cisplatin to treat elderly patients and people with other health problems because it is not as toxic.

Carboplatin has also been combined with gemcitabine. This coupling has been nicknamed “GemCarbo.” Gemcitabine and carboplatin have proven to be as effective as pemetrexed and carboplatin in fighting cancer.

The downside is that gemcitabine has a higher toxicity than pemetrexed, which is why most oncologists favor the pemetrexed combination.

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Carboplatin Clinical Trials

Currently, carboplatin is being studied in various clinical trials. A December 2022 search of the database clinicaltrials.gov revealed more than a dozen clinical studies involving carboplatin for the treatment of mesothelioma that were accepting patients or active but not yet recruiting patients.

In some studies, carboplatin (and sometimes pemetrexed) are used as a baseline to test against new therapies. Because carboplatin is considered one of the better chemotherapy agents to fight mesothelioma, scientists make comparisons against it when improving chemotherapy drugs and other mesothelioma treatments.

One Phase 2 clinical trial tested the pemetrexed and carboplatin combination alongside TTFields, a device used in alternating electric field therapy. The study attempted to determine whether delivering electrical fields to a mesothelioma tumor can help destroy it.

The researchers concluded that the trial showed “encouraging overall survival results, with no increase in systemic toxicity.” They called TTFields with pemetrexed coupled with carboplatin or cisplatin “an active and safe combination for front-line treatment of unresectable malignant pleural mesothelioma” but said more study is needed.

The Phase 2 results were published in December 2019 in The Lancet Oncology.

Another trial is reviewing pemetrexed and cisplatin, with the option to substitute for carboplatin after the first cycle, in combination with an antibody called durvalumab. Durvalumab is a checkpoint inhibitor that works by blocking molecular interactions required for normal cell growth and death cycles.

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Carboplatin Side Effects

Carboplatin is often favored over cisplatin, a similar platinum-based chemotherapy drug, because carboplatin has fewer side effects.

However, carboplatin is still an aggressive cancer-fighting drug with possible side effects.

Common carboplatin side effects include:

• Fatigue
• Hair loss
• Low blood cell counts
• Low magnesium levels
• Vomiting

About 30% of mesothelioma patients reported the above side effects.

Low blood cell counts occur when carboplatin attacks red and white blood cells along with cancer cells. Blood cell counts are typically at their lowest about 21 days after receiving the chemo drug. They usually return to normal levels within 28 days.

Some less common carboplatin side effects include:

• Abdominal pain
• Constipation
• Diarrhea
• Hearing loss
• Infection
• Kidney problems
• Mouth sores

These side effects have been recorded in 10-29% of patients receiving carboplatin.

Some patients experience peripheral neuropathy, a serious side effect that results in decreased sensation in the legs or arms.

Signs of an allergic reaction to carboplatin include shortness of breath and a sore throat that does not go away.

In most cases, carboplatin side effects are not life-threatening.

Your oncology team will order medical tests such as blood counts and kidney function tests to look for possible side effects.

Like many chemotherapy drugs, the timing and severity of carboplatin’s side effects are predictable.

Patients who experience side effects of any kind are encouraged to report them to their health care provider, who can provide guidance on normal versus abnormal reactions.

Mesothelioma Hope is here to help at this difficult time. If you’ve been diagnosed with mesothelioma, contact our Patient Advocates today at (866) 608-8933 for more information on chemotherapy and other treatment options.