A review of the pharmacokinetics and pharmacodynamics of combination carboplatin/paclitaxel. 1997

A H Calvert
Cancer Research Unit, University of Newcastle Upon Tyne, UK.

The combination of carboplatin and paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has been found to be highly active, to offer convenience of administration and better potential for dose escalation, and to produce less nonhematologic toxicity than standard therapy with cisplatin plus paclitaxel. Increased myelosuppression was anticipated to be a disadvantage of the carboplatin/paclitaxel combination, although it was expected to affect mainly platelets. Studies to date of the paclitaxel/carboplatin combination suggest the combination has a relatively benign effect on platelets compared with single-agent carboplatin. Previous pharmacokinetic studies have suggested that the measured area under the plasma carboplatin concentration-time curve is significantly less than that predicted by dosing formulas based on glomerular filtration rates. Newer evidence, however, contradicts these findings. This review examines the evidence of both a pharmacodynamic and a pharmacokinetic interaction between carboplatin and paclitaxel that has a sparing effect on platelets. It further assesses methodologic differences in methods used to estimate glomerular filtration. Paclitaxel appears to offer some protective effect for carboplatin-induced thrombocytopenia, although the two drugs do not interact pharmacokinetically. The apparent deviations of the achieved carboplatin area under the plasma concentration-time curve from that predicted by a dosing formula are thought to be due to differences in the methodology used to estimate renal function and measure creatinine. Any interaction between the two drugs most likely occurs at the level of the megakaryocyte.

UI MeSH Term Description Entries
D004347 Drug Interactions The action of a drug that may affect the activity, metabolism, or toxicity of another drug. Drug Interaction,Interaction, Drug,Interactions, Drug
D005919 Glomerular Filtration Rate The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance. Filtration Rate, Glomerular,Filtration Rates, Glomerular,Glomerular Filtration Rates,Rate, Glomerular Filtration,Rates, Glomerular Filtration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000971 Antineoplastic Combined Chemotherapy Protocols The use of two or more chemicals simultaneously or sequentially in the drug therapy of neoplasms. The drugs need not be in the same dosage form. Anticancer Drug Combinations,Antineoplastic Agents, Combined,Antineoplastic Chemotherapy Protocols,Antineoplastic Drug Combinations,Cancer Chemotherapy Protocols,Chemotherapy Protocols, Antineoplastic,Drug Combinations, Antineoplastic,Antineoplastic Combined Chemotherapy Regimens,Combined Antineoplastic Agents,Agent, Combined Antineoplastic,Agents, Combined Antineoplastic,Anticancer Drug Combination,Antineoplastic Agent, Combined,Antineoplastic Chemotherapy Protocol,Antineoplastic Drug Combination,Cancer Chemotherapy Protocol,Chemotherapy Protocol, Antineoplastic,Chemotherapy Protocol, Cancer,Chemotherapy Protocols, Cancer,Combinations, Antineoplastic Drug,Combined Antineoplastic Agent,Drug Combination, Anticancer,Drug Combination, Antineoplastic,Drug Combinations, Anticancer,Protocol, Antineoplastic Chemotherapy,Protocol, Cancer Chemotherapy,Protocols, Antineoplastic Chemotherapy,Protocols, Cancer Chemotherapy
D013921 Thrombocytopenia A subnormal level of BLOOD PLATELETS. Thrombopenia,Thrombocytopenias,Thrombopenias
D016190 Carboplatin An organoplatinum compound that possesses antineoplastic activity. cis-Diammine(cyclobutanedicarboxylato)platinum II,Blastocarb,CBDCA,Carboplat,Carbosin,Carbotec,Ercar,JM-8,NSC-241240,Nealorin,Neocarbo,Paraplatin,Paraplatine,Platinwas,Ribocarbo,JM 8,JM8,NSC 241240,NSC241240
D017239 Paclitaxel A cyclodecane isolated from the bark of the Pacific yew tree, TAXUS BREVIFOLIA. It stabilizes MICROTUBULES in their polymerized form leading to cell death. 7-epi-Taxol,Anzatax,Bris Taxol,NSC-125973,Onxol,Paclitaxel, (4 alpha)-Isomer,Paxene,Praxel,Taxol,Taxol A,7 epi Taxol,NSC 125973,NSC125973,Taxol, Bris
D019540 Area Under Curve A statistical means of summarizing information from a series of measurements on one individual. It is frequently used in clinical pharmacology where the AUC from serum levels can be interpreted as the total uptake of whatever has been administered. As a plot of the concentration of a drug against time, after a single dose of medicine, producing a standard shape curve, it is a means of comparing the bioavailability of the same drug made by different companies. (From Winslade, Dictionary of Clinical Research, 1992) AUC,Area Under Curves,Curve, Area Under,Curves, Area Under,Under Curve, Area,Under Curves, Area

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