single agent carbo side effects?

Barbara53 Member Posts: 652
edited March 2014 in Ovarian Cancer #1
My 79-year old mother's recent PT showed lesions in her chest wall, so the treatment plan has changed to single agent carbo given once every three weeks via port infusion. Mom was given a Gemzar option but declined based on quality of life issues.

Without the taxol, I'm thinking that the side effects might not be so bad compared to what she went through last year, but what do you think? As primary caregiver, I'm wondering how much I should plan to be available for duty based on the chemo, or chemo-lite as we're calling it around here.


  • gdpawel
    gdpawel Member Posts: 523 Member
    Single Agent Carboplatin
    There is a clear relationship between platinum resistance and tumor differentiation. Poorly-differentiated tumors are significantly sensitive to a platinum drug than are well-differentiated tumors. Single agent platinum is the most appropriate first line chemotherapy for poorly-differentiated tumors, while a platinum with taxol is more appropriate for well-differentiated tumors. The original American Cooperative Group trials of platinum versus non-platinum combination therapy showed that the main group of patients who benefited from platinum were patients with poorly-differentiated tumors. This has been verified in cell culture analysis.

    Single-agent carboplatin is acceptable as first-line chemotherapy for ovarian cancer, with its superior toxicity profile and equivalent survival benefit compared with other regimens, according to the results of a randomized trial reported in the August 17, 2002 issue of The Lancet.

    Based on clinical trials, results showed no difference between single agent platinums (cisplatin or carboplatin) versus platinum/Taxol (GOG Trial # 132, ICON3), the British National Institute for Clinical Excellence (NICE) determined that platinum/Taxol should no longer be considered as standard therapy and that a range of therapies are equally acceptable.

    The ICON-4 trial took patients who relapsed with so-called "platinum sensitive" disease (relapse > 6 months following last chemotherapy). They were randomized between platinum/taxol and single agent platinum. More than 80% of the platinum/taxol group got carboplatin (as opposed to cisplatin). These all got carbo at a dose of 5 (AUC), which was the same dose given to the single agent platinum group.

    Also, a lot of the patients had been treated with single agent platinum as first line therapy. The advantage of the combination was modest (10% improvement in progression free survival at one year). Plus, the combination group got more intense therapy (same dose of carbo plus the addition of another drug). Plus, a lot of the patients were "seeing" Taxol for the first time.

    The problem with this study is the complete irrelevance to the question of first line therapy. This question has been asked and answered. Twice. GOG-132 and ICON-3. Platinum-Taxol is NOT superior to single agent carboplatin and single agent cisplatin (Lancet 2002;360:500-501, 505-515).