Carboplatin — Drug Monograph

Brand names: Paraplatin

Drug class: Alkylating Agent

Mechanism of Action

Second-generation platinum compound forming intrastrand DNA cross-links similar to cisplatin but with slower aquation kinetics. Less reactive than cisplatin with proteins and glutathione, resulting in a different toxicity profile. Cell-cycle non-specific.

FDA Indications

• Advanced ovarian carcinoma (first-line in combination with paclitaxel; second-line as monotherapy)

Common Side Effects

• Thrombocytopenia (nadir days 21–28; more prominent than with cisplatin)
• Neutropenia and anemia
• Nausea and vomiting (moderate emetic risk)
• Alopecia
• Elevated liver enzymes (transient)
• Peripheral neuropathy (less common than cisplatin)
• Nephrotoxicity (less than cisplatin)

Clinical Pearl

The Calvert formula requires an accurate GFR. The Cockcroft-Gault equation is commonly used as a surrogate, but the FDA label recommends capping the GFR estimate at 125 mL/min to avoid overdosing in patients with high-normal renal function.

Related Therapies & Mechanisms

• Cisplatin (Platinol) — Alkylating Agent · NSCLC
• Pembrolizumab (Keytruda) — NSCLC
• Paclitaxel (Taxol) — Breast
• Thiotepa (Tepadina) — Alkylating Agent · Breast