Optimizing Dose-Intensity: Combining Carboplatin with Cisplatin

  • F. M. Muggia
  • I. Gill

Abstract

The rationale advanced by Trump et al1 in combining cisplatin with carboplatin included 1) the potential for less than complete cross-resistance, 2) the relative absence of overlapping toxicities, and 3) the recognized steep dose-response curve for platinum analogues. In their Phase I trial, they were able to give 50 mg/m2 of cisplatin with 400 mg/m2 of carboplatin to ‘good risk’ patients; the drugs being given as sequential 20-minute infusions. However, attempt at escalating the dose of cisplatin to 75 mg/m2 (given as 25 mg/m2 × 3d) was followed by severe thrombocytopenia in 2 of 3 patients receiving only 280 mg/m2 of carboplatin and who had tolerated carboplatin given alone in the preceding cycle.

Keywords

Ovarian Cancer Clin Oncol Buccal Cell Proc ASCO Refractory Ovarian Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    D.L. Trump, J.L. Grem, K.D. Tutsch J.K.V. Willson, K.J. Simon, D. Alberti, B. Storer and D.C, Tormey, Platinum analogue combination chemotherapy: cisplatin and carboplatin — a Phase I trial with pharmacokinetic assessment of the effect of cisplatin administration on carboplatin excretion, J Clin Oncol, 5:1281–89 (1987).PubMedGoogle Scholar
  2. 2.
    L. Levin and W.M. Hryniuk, Dose-intensity analyses of chemotherapy regimens in ovarian carcinoma, J Clin Oncol. 4:965–970 (1986).Google Scholar
  3. 3.
    M.J. Piccart, J.L. Speyer, J.C. Wernz, J. Noumoff, U. Bélier, M. Beckman, N. Dubin, R. Demopoulos and F, Muggia, Advanced ovarian cancer: three year results of a 6–8 month, 2-drug cisplatin-containing regimen, Eur J Cancer Clin Oncol, 23:631–641 (1987).PubMedCrossRefGoogle Scholar
  4. 4.
    N. Colombo, J. Speyer, M. Green R. Canetta, U. Beller, J.C. Wernz, M. Meyers, T. Widman, R.H. Blum, M. Piccart, F.M. Muggia and E. M, Beckman, Phase II study of carboplatin in recurrent ovarian cancer: severe hematologic toxicity in previously treated patients, Cancer Chemother Pharmacol, 23:323–328 (1989).PubMedCrossRefGoogle Scholar
  5. 5.
    J.L. Speyer, U. Beller, N. Colombo, J. Sorich, J.C. Wernz, H. Hochster, M. Green, R. Porges, F.M. Muggia, R. Canetta and E.M. Beckman, Intraperitoneal carboplatin: favorable results in women with minimal residual ovarian cancer after cisplatin therapy, J Clin Oncol, 8:1335–41 (1990).PubMedGoogle Scholar
  6. 6.
    R. Canetta, K. Bragman, L. Smaldone, and M. Rozencweig, Carboplatin: current status and future prospects, Cancer Treat Rev. 15:17–32 (1988) (suppl B).PubMedCrossRefGoogle Scholar
  7. 7.
    R.F. Ozols, Pharmacologic reversal of drug resistance in ovarian cancer, Semin Oncol. 12:7–11 (1985) (suppl 4).PubMedGoogle Scholar
  8. 8.
    S. Howell, S. Zimm, M. Markman, I.S. Abramson, S. Cleary, W.E. Lucas, and R.Y, Weiss, Long-term survival of advanced refractory ovarian carcinoma patients with small volume-disease treated with intraperitoneal chemotherapy, J Clin Oncol, 5:1607–1612 (1987).PubMedGoogle Scholar
  9. 9.
    R.J. Knox, F. Friedlos, D.A, Lydall and J.J Roberts, Mechanism of cytotoxicity of anticancer drugs: evidence that cis-diamminedichloroplatinum (II) and cis-diammine (1,1-cyclobutane dicarboxylato) platinum (II) differ only in the kinetics of their interaction with DNA, Cancer Res, 46:1972–9 (1986).PubMedGoogle Scholar
  10. 10.
    P.M.B. Terheggen, B.G.J. Floot, E. Scherer, A.C. Begg, A.M.J. Fichtinger-Schepman and L. Den Engelse, Immunocytochemical detection of interaction products of cis-diamminedichloroplatinum(II) and cis-diammine (1,1-cyclobutanedicarboxylato) platinum(II) with DNA in rodent tissues, Cancer Res, 47:6719–25 (1987).PubMedGoogle Scholar
  11. 11.
    E. Reed, S. Sauerhoff and M.C. Poirier, Quantitation of platinum-DNA binding after therapeutic levels of drug exposure. A novel use of graphite furnace spectrometry, Atomic Spectroscopy 9:93–5 (1988).Google Scholar
  12. 12.
    P.M.B. Terheggen, A. Dijkman, A.C. Begg, R. Dubbelman, B.G.J, Floot et al, Monitoring of interaction products of cis-diamminedichloroplatinum(II) and cis-diammine (1,1-cyclobutane-dicarboxylate) platinum(II) with DNA in cells from platinum-treated cancer patients, Cancer Res, 48:5597–5603 (1988).PubMedGoogle Scholar
  13. 13.
    I. Gill, F. Muggia, P. Terheggen, C. Michael, R.J. Parker, V. Kortes, S. Grunberg, M. C. Christian, E. Reed, L. Den Engelse, Dose-escalation study of carboplatin (day 1) and cisplatin (day 3): tolerance and relation to leukocyte and buccal cell platinum-DNA adducts, Annals Oncol, 2:115–121 (1991).CrossRefGoogle Scholar
  14. 14.
    A.H. Calvert, D.R. Newell, L.A. Gubrell, S. O’Reilly, M. Burnell, F.E. Boxall, Z.H Siddik, I.R. Judson, M.E. Gore and E, Wiltshaw, Carboplatin dosage: prospective evaluation of a simple formula based on renal function, J Clin Oncol, 7:1748–56 (1989).PubMedGoogle Scholar
  15. 15.
    R.F. Ozols, Y. Ostchega, C.E. Myers, and R.C, Young, High-dose cisplatin in hypertonic saline in refractory ovarian cancer, J Clin Oncol, 3:1246–1250 (1985).PubMedGoogle Scholar
  16. 16.
    D.R. Gandara, M.W. DeGregorio, H. Wold, B.J. Wilbur, M. Kohler, H.J. Lawrence, A.B. Deisseroth and C.B. George, High-dose cisplatin in hypertonic saline: reduced toxicity of a modified dose schedule and correlation with plasma pharmacokinetics, A Northern California Oncology Group pilot study in non-small-cell lung cancer, J Clin Oncol, 12:1787–1793 (1986).Google Scholar
  17. 17.
    R.F. Ozols, Y. Ostchega, G. Curt, R.C, Young, High dose carboplatin in refractory ovarian cancer patients, J Clin Oncol, 5:197–201 (1987).PubMedGoogle Scholar
  18. 18.
    N. Colombo, MR Pitelli, M Marzola, A Lissoni, G Gorga and C Mangioni, Randomized study of two different cisplatin dose-intensity regimens in patients with advanced epithelial ovarian cancer. Abstract P-139. 6th International Symp on Platinum, San Diego, Jan (1991), p 173.Google Scholar
  19. 19.
    C. Sessa, A. Goldhirsch, G. Martinelli, M. Alerci, L. Imburgia, and F, Cavelli, Phase I study of the combination of monthly carboplatin and weekly cisplatin, Annals Oncol, 2:123–129 (1991).CrossRefGoogle Scholar
  20. 20.
    J.R. Hardy, E. Wiltshaw, P.R. Blake, P. Harper, M. Slevin, T.J. Perrin, and S, Tan, Cisplatin and carboplatin in combination for the treatment of stage IV ovarian carcinoma, Annals Oncol, 2:131–136 (1991).CrossRefGoogle Scholar
  21. 21.
    T.C. Shea, M. Flaherty, A. Elias, J.P. Eder, K. Antman, C. Begg, L. Schipper, E. Frei III, and W. D, Henner, A phase I clinical and pharmacokinetic study of carboplatin and autologous bone marrow support, J Clin Oncol, 7:651–661 (1989).PubMedGoogle Scholar
  22. 22.
    R.P. Parker, I. Gill, F. Muggia, and E. Reed, Kinetics of platinum-DNA adduct in wbc DNA of patients receiving carboplatin and cisplatin. Proc ASCO 31:177 (1990).Google Scholar
  23. 23.
    M.J. Piccart, J.M. Nogaret, L. Marcelis, H. Longreé, F. Ries, J.P. Kains, P. Gobert, A.M. Domange, J.P. Sculier, G, Gompel, (The Belgian Study Group for Ovarian Carcinoma), Cisplatin combined with carboplatin: a new way of intensification of platinum dose in treatment of ovarian cancer, J Clin Oncol, 2:1281–9 (1987).Google Scholar
  24. 24.
    I.C. Kennedy, B.M. Fitzharris, B.M. Colls, and C.H. Atkinson, Carboplatin is ototoxic, Cancer Chemotherapy Pharm, 26:232–7 (1990).CrossRefGoogle Scholar
  25. 25.
    B. Lund, M. Hansen, O.P. Hansen, and H.H, Hansen, High-dose platinum consisting of combined carboplatin and cisplatin in previously untreated ovarian cancer patients with residual disease, J Clin Oncol, 7:1469–1473 (1989).PubMedGoogle Scholar
  26. 26.
    B. Lund, M. Hansen, O.P. Hansen, and H.H, Hansen, Combined high-dose carboplatin and cisplatin, and ifosfamide in previously untreated ovarian cancer patients with residual disease, J Clin Oncol, 8:1226–1230 (1990).PubMedGoogle Scholar
  27. 27.
    B. Lund, M. Hansen, O.P. Hansen, and H.H. Hansen, Combined high-dose platinum (carbo-and cisplatin) and etoposide in ovarian carcinoma, (ESMO Abstract P2:11) Annals Oncol. 1:11 (1990) (suppl 1).Google Scholar
  28. 28.
    C.J. Williams, Overview of ovarian cancer trials, Semin Oncol. (1991) (suppl to be published).Google Scholar
  29. 29.
    H. Kreisman, M. Goutsou, C. Modeas, and others, Cisplatin-carboplatin therapy in extensive non-small cell lung cancer: a Cancer and Leukemia Group B study, Eur J Cancer (to be published) (1991).Google Scholar
  30. 30.
    B.L. Powell, V. Stanley, J. Brockschmidt, D. White, H. Muss, L. Livesay, J. MacNeill, D. Schifeling, D. Jackson, A. Baker, D. Caldwell, M.O’Rourke, B. Paschal, R. Brodkin, M. Pavy, Combination carboplatin (CBDCA) and cisplatin (CDDP) for advanced squamous carcinoma of the head and neck (SCHN), Proc ASCO 9:179 (1990) (Abstract #693).Google Scholar
  31. 31.
    I. Dimery, R. Winn, M. Christian, K. McCarthy, and W. Hong, Combination therapy with carboplatin (CBDCA) (NSC 241240) plus cisplatin (CDDP) in recurrent squamous head and neck cancer (SHNC), Proc ASCO 9:178 (1990) (Abstract #690).Google Scholar
  32. 32.
    N. Thatcher, Communication at Ifosfamide satellite symposium. European Society of Medical Oncology (ESMO), Copenhagen, Dec 3 (1990).Google Scholar

Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • F. M. Muggia
    • 1
  • I. Gill
    • 1
  1. 1.Kenneth Norris Jr. Comprehensive Cancer CenterUniversity of Southern CaliforniaLos AngelesUSA

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