The Impact of Carboplatin Dosing Design Using Adjusted Serum Creatinine on Carboplatin Plus Paclitaxel Therapy for Ovarian Cancer

ABSTRACT Background Carboplatin (CBDCA) is a mainstay of chemotherapy for ovarian cancer and its dose is determined in proportion to the estimated creatinine clearance (CCr). Serum creatinine (SCr) values necessary to estimate CCr vary by measurement method: adding 0.2 mg/dL to SCr by enzymatic meth...

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Main Authors: Shu Kato, Kaede Baba, Kanako Mamishin, Mao Uematsu, Mai Shimura, Akira Hirota, Misao Fukuda, Nobuyuki Takahashi, Takehiro Nakao, Hiromichi Nakajima, Chikako Funasaka, Chihiro Kondoh, Kenichi Harano, Yoichi Naito, Nobuaki Matsubara, Ako Hosono, Toshikatsu Kawasaki, Toru Mukohara
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70804
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author Shu Kato
Kaede Baba
Kanako Mamishin
Mao Uematsu
Mai Shimura
Akira Hirota
Misao Fukuda
Nobuyuki Takahashi
Takehiro Nakao
Hiromichi Nakajima
Chikako Funasaka
Chihiro Kondoh
Kenichi Harano
Yoichi Naito
Nobuaki Matsubara
Ako Hosono
Toshikatsu Kawasaki
Toru Mukohara
author_facet Shu Kato
Kaede Baba
Kanako Mamishin
Mao Uematsu
Mai Shimura
Akira Hirota
Misao Fukuda
Nobuyuki Takahashi
Takehiro Nakao
Hiromichi Nakajima
Chikako Funasaka
Chihiro Kondoh
Kenichi Harano
Yoichi Naito
Nobuaki Matsubara
Ako Hosono
Toshikatsu Kawasaki
Toru Mukohara
author_sort Shu Kato
collection DOAJ
description ABSTRACT Background Carboplatin (CBDCA) is a mainstay of chemotherapy for ovarian cancer and its dose is determined in proportion to the estimated creatinine clearance (CCr). Serum creatinine (SCr) values necessary to estimate CCr vary by measurement method: adding 0.2 mg/dL to SCr by enzymatic methods commonly used in Japan equates to SCr calculated using the Jaffe method, which is widely adopted outside Japan. Although adjustment by adding 0.2 mg/dL to SCr by enzymatic methods may avoid the potential overdose of CBDCA, its impact on the dose intensity (DI) of chemotherapy is unclear. Methods We retrospectively studied patients with ovarian cancer treated with CBDCA + paclitaxel (PTX) (TC) after primary surgery. Patients were classified into Cohort A (dose‐dense [dd‐]TC, SCr‐adjusted, n = 18), B (dd‐TC, non‐adjusted, n = 8), C (tri‐weekly [tw‐]TC, SCr‐adjusted, n = 6), and D (tw‐TC, non‐adjusted, n = 15), and DI and DI‐related measures including average relative DI (ARDI, [RDI of CBDCA + RDI of PTX]/2]) known to correlate with patients’ prognoses were compared. Results Although the DI of CBDCA did not differ between Cohorts A and B, the DI of PTX and proportion of patients with ARDI ≥ 85% were higher in Cohort A than B (78 vs. 13%, p = 0.002) as a result of less frequent treatment modification. There was no difference in these measures between Cohorts C and D. Conclusion Adjustment of SCr when calculating the CBDCA dose did not compromise the DI of total CBDCA and may rather contribute to maintaining DI in patients receiving dd‐TC.
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spelling doaj-art-77ad26e1de6d426bbd447fb8d56161f72025-08-20T02:28:23ZengWileyCancer Medicine2045-76342025-04-01147n/an/a10.1002/cam4.70804The Impact of Carboplatin Dosing Design Using Adjusted Serum Creatinine on Carboplatin Plus Paclitaxel Therapy for Ovarian CancerShu Kato0Kaede Baba1Kanako Mamishin2Mao Uematsu3Mai Shimura4Akira Hirota5Misao Fukuda6Nobuyuki Takahashi7Takehiro Nakao8Hiromichi Nakajima9Chikako Funasaka10Chihiro Kondoh11Kenichi Harano12Yoichi Naito13Nobuaki Matsubara14Ako Hosono15Toshikatsu Kawasaki16Toru Mukohara17Department of Pharmacy National Cancer Center Hospital East Kashiwa JapanDepartment of Pharmacy National Cancer Center Hospital East Kashiwa JapanDepartment of Pharmacy National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanDepartment of Pharmacy National Cancer Center Hospital East Kashiwa JapanDepartment of Medical Oncology National Cancer Center Hospital East Kashiwa JapanABSTRACT Background Carboplatin (CBDCA) is a mainstay of chemotherapy for ovarian cancer and its dose is determined in proportion to the estimated creatinine clearance (CCr). Serum creatinine (SCr) values necessary to estimate CCr vary by measurement method: adding 0.2 mg/dL to SCr by enzymatic methods commonly used in Japan equates to SCr calculated using the Jaffe method, which is widely adopted outside Japan. Although adjustment by adding 0.2 mg/dL to SCr by enzymatic methods may avoid the potential overdose of CBDCA, its impact on the dose intensity (DI) of chemotherapy is unclear. Methods We retrospectively studied patients with ovarian cancer treated with CBDCA + paclitaxel (PTX) (TC) after primary surgery. Patients were classified into Cohort A (dose‐dense [dd‐]TC, SCr‐adjusted, n = 18), B (dd‐TC, non‐adjusted, n = 8), C (tri‐weekly [tw‐]TC, SCr‐adjusted, n = 6), and D (tw‐TC, non‐adjusted, n = 15), and DI and DI‐related measures including average relative DI (ARDI, [RDI of CBDCA + RDI of PTX]/2]) known to correlate with patients’ prognoses were compared. Results Although the DI of CBDCA did not differ between Cohorts A and B, the DI of PTX and proportion of patients with ARDI ≥ 85% were higher in Cohort A than B (78 vs. 13%, p = 0.002) as a result of less frequent treatment modification. There was no difference in these measures between Cohorts C and D. Conclusion Adjustment of SCr when calculating the CBDCA dose did not compromise the DI of total CBDCA and may rather contribute to maintaining DI in patients receiving dd‐TC.https://doi.org/10.1002/cam4.70804adjuvant chemotherapycarboplatincreatinineovarian cancerpaclitaxel
spellingShingle Shu Kato
Kaede Baba
Kanako Mamishin
Mao Uematsu
Mai Shimura
Akira Hirota
Misao Fukuda
Nobuyuki Takahashi
Takehiro Nakao
Hiromichi Nakajima
Chikako Funasaka
Chihiro Kondoh
Kenichi Harano
Yoichi Naito
Nobuaki Matsubara
Ako Hosono
Toshikatsu Kawasaki
Toru Mukohara
The Impact of Carboplatin Dosing Design Using Adjusted Serum Creatinine on Carboplatin Plus Paclitaxel Therapy for Ovarian Cancer
Cancer Medicine
adjuvant chemotherapy
carboplatin
creatinine
ovarian cancer
paclitaxel
title The Impact of Carboplatin Dosing Design Using Adjusted Serum Creatinine on Carboplatin Plus Paclitaxel Therapy for Ovarian Cancer
title_full The Impact of Carboplatin Dosing Design Using Adjusted Serum Creatinine on Carboplatin Plus Paclitaxel Therapy for Ovarian Cancer
title_fullStr The Impact of Carboplatin Dosing Design Using Adjusted Serum Creatinine on Carboplatin Plus Paclitaxel Therapy for Ovarian Cancer
title_full_unstemmed The Impact of Carboplatin Dosing Design Using Adjusted Serum Creatinine on Carboplatin Plus Paclitaxel Therapy for Ovarian Cancer
title_short The Impact of Carboplatin Dosing Design Using Adjusted Serum Creatinine on Carboplatin Plus Paclitaxel Therapy for Ovarian Cancer
title_sort impact of carboplatin dosing design using adjusted serum creatinine on carboplatin plus paclitaxel therapy for ovarian cancer
topic adjuvant chemotherapy
carboplatin
creatinine
ovarian cancer
paclitaxel
url https://doi.org/10.1002/cam4.70804
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