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Safety and Survival Outcomes in Lung Cancer Patients Receiving Carboplatin: Impact of Uncapped Dosage

Abstract : The prescription of carboplatin is commonly based on the Calvert formula, and low serum creatinine values can lead to an overestimation of the glomerular filtration rate and of the carboplatin dose. Limited data recommend to cap carboplatin dose at 800 mg, but the risk of suboptimal carboplatin dose is concerning. This study compared hematologic toxicity occurrence and survival outcomes in lung cancer patients receiving carboplatin > or <800 mg based on the Calvert formula (target area under the curve = 5 mg/mL min). Our results show more severe cytopenia in patients receiving carboplatin >800 mg with significant difference for all grades of thrombocytopenia in the uncapped group (37% patients vs. 3%, p = 0.02). For metastatic non-small-cell lung cancer patients, we also observed hematologic toxicity in the uncapped group with more severe anemia (30% of patients vs. 0%, p = 0.03) and all grades of thrombocytopenia (39 vs. 0%, p = 0.02) than the capped group. Concerning the secondary endpoint, we obtained a trend of lower progression-free survival and overall survival in patients receiving carboplatin >800 mg, but no significant difference appears for the both survival criteria. This study aims to improve the determination of carboplatin dosage to know the real impact of carboplatin capping and to find the optimum balance between excessive toxicity and substandard therapeutics outcomes.
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https://hal.univ-reims.fr/hal-03591781
Contributor : Marius Colin Connect in order to contact the contributor
Submitted on : Monday, February 28, 2022 - 6:29:06 PM
Last modification on : Tuesday, March 1, 2022 - 3:28:26 AM

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Antoine Le Bozec, Coralie Boulanger, Céline Mongaret, Antonin Maréchal, Maxime Dewolf, et al.. Safety and Survival Outcomes in Lung Cancer Patients Receiving Carboplatin: Impact of Uncapped Dosage. Chemotherapy, Karger, 2021, 66 (3), pp.72-77. ⟨10.1159/000516170⟩. ⟨hal-03591781⟩

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