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Comparative Study
. 2010 Jul 15;55(1):47-54.
doi: 10.1002/pbc.22467.

Comparison of two methods for carboplatin dosing in children with retinoblastoma

Steven Allen  1 , Matthew W Wilson, Amy Watkins, Catherine Billups, Ibrahim Qaddoumi, Barrett H Haik, Carlos Rodriguez-Galindo
Affiliations
Comparative Study

Comparison of two methods for carboplatin dosing in children with retinoblastoma

Steven Allen et al. Pediatr Blood Cancer. .

Abstract

Background: Carboplatin is the most effective drug in retinoblastoma but systemic clearance is variable in young patients. While most regimens use a flat dose, individualized targeting may provide a more adjusted systemic exposure.

Patients and methods: We compared carboplatin doses between two groups of children with retinoblastoma that were treated using a flat dose of 560 mg/m(2) or a targeted AUC of 6.5 using a modified Calvert formula.

Results: Ninety-eight patients with retinoblastoma received a total of 576 cycles of carboplatin (median 8 cycles). Fifty patients (51%) received a fixed dose per m(2), 32 (33%) received a dose based on AUC, 1 patient received fixed dose per kilogram, and in 15 patients a combination AUC and fixed doses was used. The median cumulative carboplatin dose (mg/m(2)) for patients who received eight cycles using fixed per m(2) dosing was 2151.8 (range, 1414.2-2852.0), compared to 1104.1 for nine patients who received eight cycles using Calvert dosing (range, 779.0-1992.7) (P < 0.001). For cycles given using AUC, the median percentage of the hypothetical fixed per m(2) dose was 70% (range, 48-134%). Younger patients had larger differences. Patients receiving carboplatin based on fixed per m(2) dosing were 3.0 times more likely to have a platelet transfusion (95% confidence interval, 1.3-7.3).

Conclusions: Carboplatin administration needs to consider the changes in renal function occurring during the first months of life. The use of a targeted AUC provides the most accurate method; however, mg per kg of body weight dosing is a very reliable alternative method.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Scatter plots showing the association between age at diagnosis and fixed per m2 dose received/hypothetical Calvert dose (for patients who received fixed per m2 doses during cycle 1) (n=54) (A); and the association between age at diagnosis and Calvert dose received/hypothetical fixed per m2 dose (for patients who received Calvert doses during cycle 1) (n=40) (B).
Figure 2
Figure 2
Profiles of GFR Values with Average Trend Line.
See this image and copyright information in PMC

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