Carboplatin

Carboplatin is a chemotherapy drug approved by the Food and Drug Administration (FDA) in 1989. Its brand name is Paraplatin. This drug has fewer side-effects than other chemotherapy drugs such as Cisplatin. For that reason, doctors may recommend its use. Carboplatin is a modified form of Cisplatin which was approved for use in the 1970s. Although Carboplatin is most commonly used to treat head, lung, ovarian, and neck cancers, it has also shown some effectiveness in treating mesothelioma.

Chemotherapy drugs work in different ways. Carboplatin works by breaking through the cell wall and attaching to the cell's DNA. This prevents the cell from dividing and functioning normally and eventually the cell dies. Cancer cells divide very rapidly. Certain drugs like Carboplatin are attracted to such cells and therefore are able to target specific cancer cells. In this sense, Carboplatin acts like an alkylating agent which means it attaches to the cancer cell's DNA leading to the cell's death.

Carboplatin Used in Treatment of Mesothelioma

Doctors and researchers are constantly searching for more effective ways to treat cancers, including mesothelioma. Many clinical trials are underway in which various chemotherapy drugs are combined to determine whether that combination is more effective than present treatment protocols. Clinical trials are conducted to find new combinations of chemotherapy drugs to fight mesothelioma. Carboplatin is used in some of these clinical trials in combination with other drugs in the hope of finding a more effective treatment for mesothelioma.

There are Phase I Clinical Trials combining Carboplatin and other drugs to determine whether such combinations may be effective in fighting mesothelioma. Once researchers have found that a drug combination appears promising, Phase II Clinical Trials are conducted. There are many Phase II Clinical Trials involving chemotherapy drugs, including Carboplatin.

Results of completed clinical trials show that Carboplatin in combination with Alimta (Pemetrexed) may be as effective in treating mesothelioma as is the combination of Alimta and Cisplatin, with less toxicity and adverse side-effects. In 2007, an Italian group of researchers published in the Annals of Oncology the results of a Phase II clinical trial that studied the combination of Carboplatin and Alimta in 76 patients who were diagnosed with malignant pleural mesothelioma. The researchers found the combination to be moderately effective with acceptable toxicity.

In a much larger study conducted by another group of Italian researchers, 1704 chemonaive patients (patients who had not been previously treated with chemotherapy drugs) diagnosed with malignant pleural mesothelioma were given either a combination of Alimta and Cisplatin or Alimta and Carboplatin. The results confirmed that the Alimta and Cisplatin combination were active in fighting the disease. The study further concluded that the combination of Alimta and Carboplatin was as effective as Alimta and Cisplatin. This study was published in the Journal of Thoracic Oncology on July 3, 2008. A similar conclusion was reached by United Kingdom scientists who studied 49 patients with malignant pleural mesothelioma and who were treated with Carboplatin and Alimta.

In the Journal of the Egyptian National Cancer'Institute, a group of Egyptian researchers published the results of a prospective Phase II clinical trial of 42 patients with malignant pleural mesothelioma who were treated with Gemcitabine (another chemotherapy drug) and Carboplatin. This study concluded that this particular drug combination may be a viable option in the treatment of the disease.

On-going Clinical Trials Involving Carboplatin to Treat Mesothelioma

There are several on-going clinical trials that will use Carboplatin in combination with other chemotherapy drugs to treat mesothelioma. These clinical trials are currently recruiting patients.

In a Phase II clinical trial, Danish researchers are studying the use of Carboplatin and Vinorelbine, a chemotherapy plant alkaloid. In another international study, Italian scientists are conducting a Phase II clinical trial using Bevacizumab, Alimta, and Carboplatin in combination to treat malignant pleural mesothelioma. A clinical trial being conducted at the H. Lee Moffitt Cancer Center and Research Institute in Florida will use the same drug combination being studied by the Italian researchers. Finally, the drug manufacturer Pfizer is conducting a Phase I clinical trial using Alimta, Cisplatin, and Carboplatin in different combinations with the drug Sunitinib, also known as SU011248. Sunitinib is a chemotherapy drug used in the treatment of gastrointestinal stromal tumors (GIST) that have not responded to treatment with Gleevec.

Administering Carboplatin and Potential Side-Effects

Chemotherapy drugs can be administered orally or intravenously, which consists of administering liquid substances directly into a vein. Intravenous therapy, commonly referred to as IV therapy, is the fastest way to administer medications to the body. Carboplatin is usually administered through an IV.

The greatest benefit of Carboplatin is its reduced side-effects, particularly when compared to Cisplatin. There is less nausea when Carboplatin is used. Even though the side-effects may be less severe, patients taking this medication can still expect to experience some side-effects. These side- effects include hair loss, nausea and vomiting, fatigue or weakness, and loss of appetite.

One of the main complications that can develop is bone marrow suppression where the blood cell and platelet output of bone marrow decrease dramatically. In some patients, these levels can go as low as 10% of their usual production levels. The decrease in white blood cells can lead to an increased probability of infection and a greatly compromised immune system.