This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kaestner, S. Articles by Sewell, G. Search for Related Content PubMed PubMed Citation Articles by Kaestner, S. Articles by Sewell, G. Social Bookmarking                   What's this?

Dose-banding of carboplatin: rationale and proposed banding scheme

Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, UK

Graham Sewell

Department of Pharmacy, Kingston University, Kingston-on-Thames KT1 2EE, UK and Plymouth Hospitals NHS Trust, Plymouth PL6 8DH, UK, G.J.Sewell{at}kingston.ac.uk

Background. In dose-banding (DB) prescribed doses of cancer chemotherapy are fitted to doseranges or ‘bands’ and standard doses for each band are provided using a selection of pre-filled infusions or syringes, either singly or in combination. DB is used for several drugs where dose is based on body surface area. No DB-scheme has been reported for carboplatin, which, in clinical practice, is routinely dosed according to renal function.

Study objective. To assess the rationale for DB of carboplatin with regards to factors that influence dosing accuracy, develop a DB scheme, and discuss its potential use and limitations.

Methods. Prospective evaluations of carboplatin area under the plasma concentration – time curve (AUC) following application of the Calvert-formula were identified by a literature search. A relevant carboplatin dose range for construction of a DB-scheme with Calvert-formula based doses was obtained from published glomerular filtration rate distributions for patients receiving carboplatin.

Results. A DB-scheme was developed for individually calculated carboplatin doses of 358–1232 mg, with 35 mg increments between each standard dose and a maximum deviation of 4.7% from prescribed dose. The proposed DB-scheme covers the GFR-ranges 47–221 mL/min and 26–151 mL/min for patients receiving doses based on the target AUCs of 5 and 7 mg/mL/min, respectively.

Conclusion. There is a strong scientific rationale to support DB of carboplatin. The proposed banding scheme could introduce benefits to patients and healthcare staff but, as with other DB schemes, should be validated with prospective clinical and pharmacokinetic studies to confirm safety and efficacy.

Key Words: Calvert-formula • carboplatin • dose-banding • renal function

Journal of Oncology Pharmacy Practice, Vol. 13, No. 2, 109-117 (2007)
DOI: 10.1177/1078155207080801


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. Kaestner and G. Sewell A sequential temperature cycling study for the investigation of carboplatin infusion stability to facilitate `dose-banding' Journal of Oncology Pharmacy Practice, June 1, 2007; 13(2): 119 - 126. [Abstract] [PDF]