CARBOCISPLATIN

Carboplatin vs Cisplatin

Carboplatin is a  chemotherapy   drug  used against some forms of  cancer . It is usually recommended to patients with ovarian carcinoma cancer; lung, head and neck cancers as well as endometrial, esophageal, bladder, breast and cervical cancer; central nervous system or germ cell tumors; osteogenic sarcoma, and as a preparation for stem cell or bone marrow transplant.

Carboplatin was introduced in the 1980s and is also called cis-Diammine(1,1-cyclobutanedicarboxylato) platinum(II), and has the trade names Paraplatin and Paraplatin-AQ. [1]   Since its introduction, Carboplatin has gained popularity as a clinical treatment because it can reduce side-effects compared to its parent compound  cisplatin . Cisplatin and carboplatin belong to the group of  platinum-based antineoplastic  agents, and interact with  DNA  to interfere with  DNA repair .

Carboplatin is on the  World Health Organization's List of Essential Medicines , which identifies some of the very important medication provided by a good basic  health system . [2]

Current events

According to a research study on mutant mice, the results suggest that in the subset of females with breast cancer due to BRCA1 and BRCA2 genes (these cause a variety of familial breast cancer) carboplatin may be as much as 20 times more effective than the usual breast cancer treatments. [6]   Similar results in humans still has not yet been shown.

Carboplatin has also been used to treat testicular cancer patients with stage 1  seminoma . This additional research indicates that this treatment is more effective and has fewer side effects than adjuvant radiotherapy. [7] [8] [9]  And, in comparison to radiotherapy, Carboplatin is much more effective at preventing a second testicular cancer developing in the other testicle. [10]

Side-effects

The greatest benefit of carboplatin is its reduced side effects in comparison to cisplatin. Carboplatin helps with the elimination of effects caused by nephrotoxicity, as well as reducing less severe side effects such as Nausea  and  vomiting , which carboplatin helps to control.

Carboplatin has a major drawback in that it causes the  blood   cell  and  platelet  output of bone marrow in the body to decrease quite dramatically. This is called the myelosuppressive effect, and with carboplatin its sometimes as low as 10% of its usual production levels.

The low point of myelosuppression  can happen 21ľ28 days after the first chemotherapy treatment. Then the blood cell and platelet levels in the blood usually begin to stabilize, often nearly returning to its pre-carboplatin levels. The decrease in  white blood cells (called neutropenia ) can sometimes bring complications which can be treated with drugs like  filgrastim . A common complication of neutropenia is the chance of increased infection by organisms seeking an opportunity, and this makes it necessary for a patient to get readmission to a hospital in order to receive treatment with  antibiotics .

Depending on the strain of cancer being treated, carboplatin may only be 1/8 to 1/45 as effective as cisplatin because it is less potent. In comparison to cisplatin, a typical clinical dosage of carboplatin is a 4:1 ratio. To get the same effective results, it takes four times more carboplatin per dose than is usually required with a dose of cisplatin.

There are two important characteristics about carboplatin's stability: 1) once absorption of the drug occurs, carboplatin's retention half-life is considerably longer than cisplatin; 2) but, its inertness causes carboplatin to pass quickly through the body with nearly 90% of it recovered in urine.

There is research examining a method whereby the effectiveness of carboplatin can be increased by first incubating carboplatin in a  sodium chloride  (NaCl) solution, followed by several steps of separating compounds from the solution. Several trials have results suggesting that as incubated carboplatin solution is administered to cancer cells, they began to shrink and eventually die; apparently by the same mechanism that cisplatin works

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