1998
DOI: 10.1634/theoncologist.3-1-15
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New Perspectives on an Old Friend: Optimizing Carboplatin for the Treatment of Solid Tumors

Abstract: Background. Since its clinical introduction in 1981, carboplatin has proved a feasible alternative to cisplatin for the treatment of many solid tumors, especially ovarian cancer. Because the pharmacokinetics and, ultimately, the pharmacodynamics of carboplatin are highly dependent on the status of renal function, fixed dosing based on body surface area has led to carboplatin overdosing or, especially, underdosing. This has resulted in less than optimal treatment results compared with cisplatin in a variety of … Show more

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Cited by 62 publications
(34 citation statements)
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“…With the exception of carboplatin [11,12], it was a long time before concerns were raised on the relevance of using BSA in oncology. Currently, many studies have been performed, which clearly show that (most frequently) BSAbased dosing does not yield the desired minimization in interindividual variation in exposure in adults.…”
Section: Historic Development Of Body Surface Area-based Dosingmentioning
confidence: 99%
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“…With the exception of carboplatin [11,12], it was a long time before concerns were raised on the relevance of using BSA in oncology. Currently, many studies have been performed, which clearly show that (most frequently) BSAbased dosing does not yield the desired minimization in interindividual variation in exposure in adults.…”
Section: Historic Development Of Body Surface Area-based Dosingmentioning
confidence: 99%
“…However, the association between BSA and GFR is weak [38]. Therefore, in the case of carboplatin, a drug almost completely excreted by the kidneys, dosing based on BSA may result in serious patient under-and overdosing [12]. This urged the wish for better predictors of pharmacokinetic measures than BSA.…”
Section: Why Do Some Drugs Relate To Bsa?mentioning
confidence: 99%
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“…Model predictions generated scaling our mathematical model (Eqs. [1][2][3][4][5][6][7][8][9] to reflect the differences between rat and human haematopoiesis physiology (e.g., population size, maturation time, etc. ), but using the drug-effect parameters estimated in rats did not reflect accurately either clinical neutropenia or thrombocytopenia (Figure 4).…”
Section: Clinical Predictionsmentioning
confidence: 99%
“…Calvert's formula, calculating the dose of carboplatin as a function of glomerular filtration rate (GFR) and target AUC, has been employed in numerous research studies over the past several decades. 3,4 Indeed, the clinical utility of individualized carboplatin dosing is now being further advanced through the adoption of therapeutic drug monitoring (TDM) approaches to achieve target AUC values in specific patient populations where there are particular concerns over toxicity. [5][6][7] Pediatric-specific carboplatin adaptive dosing formulas are similar to Calvert's formula but attempt to take into account developmental Pediatr Blood Cancer.…”
Section: Who Demonstrated Amentioning
confidence: 99%