Paraplatin (Carboplatin)

Carboplatin is a platinum-based chemotherapy drug also sold under the brand name Paraplatin. Bristol-Myers Squibb is that main manufacturer of Paraplatin. However, there are now several companies that make the generic carboplatin. Carboplatin used to treat a number of different cancers and is administered intravenously every few weeks.

Developed after cisplatin, carboplatin is an additional optionfor doctors. Side effects of carboplatin are typically less severe, although the drug still poses some risk. Carboplatin is an important chemotherapy drug for patients with mesothelioma and can be used in combination with several other drugs after surgical treatment or when surgery is not advised.

What is Carboplatin?

Carboplatin, or Paraplatin was developed and patented in the 1970s. However, this platinum-based chemotherapy drug was not approved by the U.S. Food and Drug Administration (FDA) until 1986. This was nearly a decade after the similar drug, cisplatin, had been on the market.

Carboplatin was derived from cisplatin, its parent drug. Therefore, the two drugs have similar properties and uses. Paraplatin is made by Bristol-Myers Squibb, while generic carboplatin is made by Hospira, Teva Pharmaceuticals, and other companies.

Like cisplatin, carboplatin works by targeting and interfering with the how rapidly-growing cells grow and divide. Unfortunately, this drug does not differentiate between cancer cells and other healthy cells that grow and divide quickly. The lack of specificity, as well as the presence of platinum, causes a number of potential side effects.

Carboplatin is ainly used in combination with other drugs to treat ovarian cancer. However, this drug has also been tested and used for a number of other cancer types, including mesothelioma and lung cancer.

Carboplatin is administered through intravenous injection. The procedure takes about 15 minutes for each injection, and an injection is given approximately every four weeks. Carboplatin is administered by a doctor or nurse in a medical facility setting.

Carboplatin for Mesothelioma

Although carboplatin is not officially approved for mesothelioma treatment, it is a popular choice, especially when used in combination with other chemotherapy drugs. Patients may develop a resistance to carboplatin when it is used alone. Cancer cells often develop immunity to carboplatin, leading to relapse.  Combining carboplatin with other drugs can reduce resistance.

A common drug combination for pleural mesothelioma is carboplatin with pemetrexed, also known as Alimta. This is also a common combination with cisplatin. Some studies have shown that both combinations, result in similar outcomes. Doctors choose the specific combinations based on how the patient tolerates each drug.

Other recent trials using carboplatin included its use with Alimta in elderly patients with mesothelioma. The results showed that elderly patients tolerated the combination nearly as well as a younger group of participants. The older patients also had similar disease outcomes and survival times.

Another group of trials has not yet yielded significant results. These studies are combining carboplatin and Alimta with a third drug, bevacizumab. Bevacizumab is a chemotherapy drug that works in a different way. The trial was non-randomized, and therefore limited. Researcher hope to test the combination again more effectively.

Common Side Effects of Carboplatin

Carboplatin is often preferred over cisplatin because it causes fewer side effects. Side effects are not only uncomfortable for the patient, but may also limit medication dosage. The fewer side effects, the greater the amount of medication a patient can tolerate.

Carboplatin causes common side effects including nausea, diarrhea, vomiting, constipation, mouth sores, pain and tingling in hands and feet, irritation in the skin at the injection site, pain, weakness, hair loss, and loss of taste for food. Most of these are less severe and less common compared to cisplatin. Another big advantage of carboplatin over cisplatin is that it does not cause toxicity in the kidneys, a serious potential complication of cisplatin.

Carboplatin Black Box Warnings

The FDA uses a special warning label on medications for the most severe and life-threatening side effects and complications. Carboplatin comes with a few black box warnings. Both patients and doctors should weigh the risks and consequences with the potential benefits of this drug.

One serious warning for carboplatin is that it may suppress bone marrow. The risk of this side effect increases with dosage. Bone marrow suppression can be severe and can result in anemia, bleeding, and infections. The issue can be severe enough to require blood transfusions. Bone marrow produces new blood cells, so suppression leads inadequate red blood cells and anemia. Bone marrow suppression can also affect the production of white blood cells, leading to infection.

Another black box warning is aimed at patients with severe allergies to carboplatin injections. These severe reactions may not be discovered until after the first dose. These patients may suffer anaphylactic shock, which can be fatal wthout immediate treatment. Signs of a severe reaction include hives and irritation at the injection site, swelling in the face, mouth, and throat, and difficulty breathing.

Carboplatin is a drug that was developed from cisplatin. Although these drugs are similar, there are significant differences. Some patients tolerate carboplatin better, but it comes with serious risks. The worst risk is the drastic reduction in blood cells, resulting in anemia and a weakened immune system. Patients with mesothelioma may be given carboplatin if they cannot tolerate cisplatin. For many of these patients, it will provide good results, especially when taken in combination with other drugs.