From the Guidelines
The standard carboplatin-paclitaxel regimen for metastatic uterine cancer typically involves carboplatin at an area under the curve (AUC) of 5-6 and paclitaxel at 175 mg/m² administered intravenously every 3 weeks, as seen in the GOG 209 study 1. This regimen is effective because carboplatin forms DNA crosslinks disrupting cancer cell division, while paclitaxel stabilizes microtubules preventing cell division. Some key points to consider when administering this regimen include:
- Dosing must be tailored based on the patient's body surface area, renal function, performance status, prior treatments, and comorbidities.
- Treatment cycles usually continue for 6 cycles, but this varies based on response and toxicity.
- Patients require regular monitoring of blood counts, renal function, and neurological status during treatment.
- This chemotherapy regimen should only be administered by qualified oncologists who can properly calculate doses, manage side effects, and adjust treatment as needed. It's also worth noting that alternative regimens, such as dose-dense paclitaxel and carboplatin, have shown promise in certain studies, including the Japanese study (NOVEL–JGOG 3062) 1. However, the standard carboplatin-paclitaxel regimen remains a widely accepted and effective treatment option for metastatic uterine cancer. The NCCN guidelines also support the use of carboplatin and paclitaxel in the treatment of ovarian cancer, with recommended dosages and schedules outlined in the guidelines 1.
From the Research
Dosage Information for Carboplatin and Paclitaxel in MTS Uterine Cancer
- The dosage of carboplatin and paclitaxel for advanced or recurrent endometrial carcinoma is carboplatin [area under the curve (AUC) 5] and paclitaxel 175 mg/m(2) every 3 weeks for 6-9 cycles or until disease progression or unacceptable toxicity 2.
- In another study, the combination of carboplatin, paclitaxel, and pegylated liposomal doxorubicin was used, with carboplatin (AUC 5), paclitaxel 175 mg/m(2), and pegylated liposomal doxorubicin 25 mg/m(2) every 3 weeks for 6-8 cycles 3.
- A phase I study of paclitaxel, carboplatin, and pegylated liposomal doxorubicin in ovarian and peritoneal carcinoma found that paclitaxel 175 mg/m(2), carboplatin (AUC=5), and pegylated liposomal doxorubicin 30 mg/m(2) are tolerable without supportive therapy 4.
- In a study of paclitaxel/carboplatin in a dose-dense or weekly regimen in patients with recurrent or primary metastatic cervical cancer, the dosage was paclitaxel (90 mg/m(2)) and carboplatin (area under the curve (AUC) 4) administered on d1, d8 q3 wks in the dose-dense regimen, and paclitaxel (60 mg/m(2)) and carboplatin (AUC 2.7) administered weekly in the weekly regimen 5.
- The MITO-2 randomized phase III trial compared carboplatin plus paclitaxel with carboplatin plus pegylated liposomal doxorubicin as first-line treatment for patients with ovarian cancer, using carboplatin area under the curve (AUC) 5 plus paclitaxel 175 mg/m(2) or carboplatin AUC 5 plus pegylated liposomal doxorubicin 30 mg/m(2), every 3 weeks for six cycles 6.