Carboplatin Hypersensitivity

One of my family members has Ovarian Cancer.  She had Carboplatin and Taxol for the first set of chemotherapy over a year and a half ago.  Her Cancer has come back again and the new chemotherapy treatment they are using is Carboplatin and Doxil.  She has a been sicker than she ever was with the first set of chemo.  We believe this is a reaction to the Doxil (the new drug) but have been told that it is because of a build-up of Carboplatin from her treatments over a year and a half ago.  Has this happened to anyone else and what were your symptoms? Did you continue using the same treatment or did you try something else?  

LorettaMarshall said:

Opal~DOXIL doesn't work 4 all~Not familiar w/Carbo buildup !

Dear Opal

Am truly sorry to read of another person with Ovarian Cancer.  Your family member is not the only one having a problem with Doxil.  You might want to read remarks in this link:  https://csn.cancer.org/node/309820

Right out of the gate, I was diagnosed with a Stage IV cancer that was first found in my Peritoneal cavity.  A 2^nd opinion found it was also in my ovaries, so most likely it began in my ovaries and spread to my abdominal cavity.  So Peritoneal Carcinomatosis was my first diagnosis, and secondly the Ovarian Cancer was found.  During my days since November of 2012, I have had 4 different sessions of Carboplatin/Paclitaxel (Taxol) as my chemotherapy regimen.  This was given each time as a 6-regimen session at 3-week intervals.  I just completed my 4^th session in late May 2018.   However, this is the first time that my tumor markers (CA-125) began to rise rapidly once again soon after completion of my last treatment.    Initially, the numbers came down considerably, but went back up just as quickly once I was off of this combo.  I knew I was taking a chance trying it for the 4^th time, but I told my oncologist, “I’m simply not going to take DOXIL.  I’ve read too many side effects that are worse than the ones I’ve been able to tolerate with Carbo/Taxol.”  He always listens to me and if I am adamant about what I wish—that’s the way it is. 

Now I had already read that a person can still be “platin sensitive” after repeated treatments with the same combination.  However, just like with anti-biotics—repeated  habitual use will limit its effectiveness.  Although, I’m Stage IV, I’m not desperate enough to “try anything.”  My quality of life level is my marker for what I will take or will not take.  “Burning & stinging blisters on the soles of my feet or the palms of my hands was not one of the side effects I was willing to risk.  I knew what I was able to tolerate with the Carboplatin/Paclitaxel (Taxol) regimen.  Sure enough, the symptoms were fairly consistent with me.  But this time, it just did not last long enough to take it again. 

Clinical trials have shown that Carbo/Paclitaxel (Taxol)  have shown to be the most effective for the greatest number of OC patients, but when we’ve used up that option—what then?  That’s where I am at present.  With Stage IV, I’m not facing recurrence, I’m facing further metastasis.  Yet, I’m not desperate enough to take something that has a “limited-dosage” factor, and has potentially worse side effects than I have already tolerated. 

As I’ve said repeatedly, “I’m a firm believer in Psalm 139.”  Therein the Psalmist is conversing with the Lord in his spirit and saying, “Lord You saw me when I was being knit together in my mother’s womb, and in Your Book, ALL the days of my life were written when as yet there were none of them.”  Others may disagree, but for me, I believe that the number of my days are known only to God, and that I’m not going to die one day sooner or live one day longer than my allotted number of days on this earth.  Heaven awaits at some point.  Although there will come a time, no doubt, that I will have to say, “Enough already—I’m out of options,” I’m not quite there yet, but I do believe the time is nearer than when I was first diagnosed back in November of 2012.  I’ve already been blessed to live over twice as long as the stats for my kind of cancer indicate.  I’ve been to the best doctors and had the best of care and continue to have access to whatever I think I need.  All my specialists are willing to work with me, but we are all on the same page.  I’m holding no allusions of being cured, but my times are truly in God’s hands.  He could cure me if He wanted to, but He doesn’t have to. 

I can’t tell you what your family member intends to do.  If it were me, I would probably opt for a second go-round of the same drugs that kept her cancer at bay for a year and a half.  My own progression-free-survival record has been shown to be only about 10 to 12 months between situations that call for another round of treatments.  Just thought you might like to know that more than one person has not been happy with the DOXIL regimen.  That was what my oncologist suggested, but I was not willing to take the risk of being even “sicker” than at previous times.  It would appear that your family member was “platin sensitive” meaning she did respond to the Carbo/Taxol regimen. 

In times past my oncologist has done a PET/CT scan after 3 treatments to ascertain its effectiveness.  Perhaps you could suggest to your relative that she be tested to see if DOXIL is really having a good effect in bringing down her cancer count.  If not, seems she could always discuss repeating the same chemo combo that she first took.  It’s just a suggestion.  However, it’s our life that hangs in the balance, and I, for one, certainly have a voice and expect to have the final say-so in what I will do and will not do.  In early stages, chemo may be effective and kill all the cancer, and it may never return.  But as a Stage IV, my options are certainly down to a precious few.  But I intend to have the “last word”.  Isn’t that always our female prerogative? 

Wishing your relative better days than those she is having now.  Another chemo option might help in that regard.

Loretta

Peritoneal Carcinomatosis/Ovarian Cancer Stage IV

P.S.  I really don’t know anything about “Carboplatin buildup”.  Seems to me that as long as the Carboplatin is in the system, it’s killing cancer.  And if the cancer returns again, it would seem that there was no longer any Carboplatin left in her system.  Since I’m the patient, and not the nurse, I always ask questions.  Seems Carboplatin “sensitive” and Carboplatin “buildup” would be two different animals.  When I see my oncologist next, I’ll ask him to tell me if there is any such thing!  I’m not saying there is no such thing—I’m just saying since I’ve never heard of it, I can’t comment intelligently about it.  I'm wondering why, if she already had a buildup of Carboplatin in her system left over from a year and a half ago, why would they prescribe Carboplatin again?  Just asking....Hhmmm  

Thank you, Loretta.  Those are excellent points.  We wondered the same thing about the build up.  Maybe Carboplatin Sensitivity is the term we were looking for...

Feelingalone74 said:

Carboplatin and taxol

Hi ladies God bless you all in the house Journey that you've been on and I hope today you can continue to get better each day.

I learned this week that I will have to be getting chemotherapy in a couple weeks. Myvdoctor in for me that to chemotherapy I will be receiving a taxol and carboplatin.  I know everybody is body respond differently to medications and treatments. But I was surprised when he said that I would not feel sick when I asked him if I would. I'm hoping I won't but I'm just wondering what has been all of your experiences he also said as long as I feel well enough that I will be able to continue working. What has your experience has been as far as being able to work?

Thank you

Hi Feelingalone,

Everyone is affected differently by these two drugs, which are the standard treatment for ovarian cancer.  Some women have only mild side effects, while others' are more severe.  Maybe your doctor was telling you you wouldn't be sick because they do give you drugs to counteract the nausea some people experience after treatments.  Perhaps that is what he was referring to. 

Really all you can do is play it by ear and see how you feel.  Some women can work through treatments, while others cannot.  It's very individual.  See how you feel and be gentle with yourself.  Trying to push yourself might end up being counterproductive if you are not feeling well.

I wish you luck with your treatments.