Abstract
Carboplatin is a chemotherapeutic agent frequently used in the treatment of various malignancies. An individual dosing strategy has been recommended to yield the most optimal exposure, expressed as the area under the concentration-time curve (AUC). The formula developed by Calvert et al. (dose = target-AUC × [GFR+25]) can be used to achieve this. However, due to the inconvenient [51Cr]-ethylenediaminetetraacetic acid ([51Cr]-EDTA)-based measurement of the glomerular filtration rate (GFR), its application in the clinic has thus far been limited. Chatelut and coworkers have recently proposed a formula to estimate carboplatin clearance using the serum creatinine concentration. We retrospectively tested the Chatelut equation and the Calvert formula using either the creatinine clearance based on 24-h urine collection or the creatinine clearance based on the formula of Cockcroft and Gault. The latter equations were shown to predict the carboplatin clearance reasonably well, although systematic overprediction and underprediction occurred. However, the formula proposed by Chatelut and co-workers had no significant bias and was precise. It is proposed that this formula be used to calculate the optimal carboplatin dosage after prospective validation has been performed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Calvert AH (1994) Dose optimisation of carboplatin in adults. Anticancer Res 14:2273
Calvert AH, Newell DR, Gumbrell LA, O'Reilly S, Burnel M, Boxcall FE, Siddik ZH, Judson JR, Gore ME, Wiltshaw E (1989) Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol 7:1748
Calvert H, Judson I, Vijgh WJF van der (1993) Platinum complexes in cancer medicine: pharmacokinetics and pharmacodynamics in relation to toxicity and therapeutic activity. Cancer Surv 17:189
Chatelut E, Brunner V, Pujol A, Chevreau C, Roché H, Mutin P, Houert C, Houin G, Bugat R, Canal P (1994) Formula based on patient characteristics to predict the carboplatin (CBDCA) clearance. Ann Oncol 5 [Suppl 8]:191
Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum cretainine. Nephron 16:31
Daugaard G, Roosing N, Rorth M (1988) Effects of cisplatin on different measures of glomerular function in the human kidney with special emphasis on high-dose treatment. Cancer Chemother Pharmacol 21:163
Egorin MJ, Van Echo DA, Tipping SJ, Olman EA, Whitacre MY, Thompson BW, Aisner J (1984) Pharmacokinetics and dosage reduction ofcis-diammine(1,1-cyclobutanedicarboxylato) platinum in patients with impaired renal function. Cancer Res 44:5432
Gibaldi M, Perrier D (1982) Pharmacokinetics 2nd edn. Marcel Dekker, New York Basel
Green JA, Smith K (1990) Dose intensity of carboplatin in combination with cyclophosphamide or ifosfamide. Cancer Chemother Pharmacol 26 [Suppl]:S22
Jodrell DI, Egorin MJ, Canetta RM, Langenberg P, Goldbloom EP, Burroughs JN, Goodlow JL, Tan S, Wiltshaw E (1992) Relationships between carboplatin exposure and tumor response and toxicity in patients with ovarian cancer. J Clin Oncol 10:520
Luke DR, Halstenson CE, Opsahl JA, Matzke GR (1990) Validity of cretainine clearance estimates in the assessment of renal function. Clin Pharmacol Ther 48:503
Marina NM, Rodman J, Shema S, Bowman LC, Douglas E, Furman W, Santana VM, Hudson M, Wiliams J, Meyer W, Madden T, Pratt C (1993) Phase I study of escalating targeted doses of carboplatin combined with ifosfamide and etoposide in children with relapsed solid tumor. J Clin Oncol 11:554
Reyno LM, Egorin MJ, Canetta RM, Jodrell DI, Swenerton KD, Pater JL, Burroughs JN, Novak M, Sridhara R (1993) Impact of cyclophosphamide on relationships between carboplatin exposure and response or toxicity when used in the treatment of advance ovarian cancer. J Clin Oncol 11:1156
Sessa C, Goldhirsch A, Martinelli G, Alcerci, Imburgia L, Cavalli F (1991) Phase I study of the combination of monthly carboplatin and weekly cisplatin. Ann Oncol 2:123
Sheiner LB, Beal SL (1981) Some suggestions for measuring predictive performance. J Pharmacokinet Biopharm 9:503
Sørensen BT, Strömgren A, Jakobsen P, Nielsen JT, Andersen LS, Jakobsen A (1992) Renal handling of carboplatin. Cancer Chemother Pharmacol 30:317
Sørensen BT, Strömgren A, Jackobsen P, Jakobsen A (1993) Is creatinine clearance a sufficient measure for GFR in carboplatin dose calculation? Eur J Cancer 29:S110
Vermorken JB, Bokkel Huinink WW ten, Eisenhower EA, Favalli G, Belpomme D, Conte PF, Kaye SB (1993) Carboplatin versus cisplatin. Ann Oncol 4 [Suppl 4]:S41
Vijgh WJF van der (1991) Clinical pharmacoknetics and carboplatin. Clin Pharmacokinet 21:242
Wagstaff AJ, Ward A, Benefield P, Heel RC (1989) Carboplatin, a preliminary review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the treatment of cancer. Drugs 37:162
Warmerdam LJC van, Tellingen O van, Maes RAA, Beijnen JH (1995) A validated method for the analysis of carboplatin using Zeeman atomic absorption spectrometry. Fres J Anal Chem 351:1820
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
van Warmerdam, L.J.C., Rodenhuis, S., ten Bokkel Huinink, W.W. et al. Evaluation of formulas using the serum creatinine level to calculate the optimal dosage of carboplatin. Cancer Chemother. Pharmacol. 37, 266–270 (1995). https://doi.org/10.1007/BF00688327
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00688327