Key result
Actual-weight carboplatin dosing in obesity is linked to greater toxicity than adjusted weight without survival benefit.
Why the study?
To describe carboplatin dosing criteria in obese patients in routine clinical practice, and evaluate associated toxicity and effectiveness across major diagnoses.
Does carboplatin dosing by actual body weight compared to ideal adjusted body weight affect toxicity and survival in obese patients?
Observational
No
Does carboplatin dosing by actual body weight compared to ideal adjusted body weight affect toxicity and survival in obese patients?
In obese patients, carboplatin dosing based on actual body weight increases toxicity without improving survival compared to ideal adjusted body weight.
May support ideal adjusted body weight dosing to limit toxicity in obese patients; leaves open need for randomized confirmation of survival equivalence.
OBJECTIVES: The study aimed to: 1) Describe the carboplatin dosing criteria in obese patients in routine clinical practicein a general university hospital. 2) Evaluate toxicity based on the dosing criterion used. 3) Assess effectiveness in major diagnoses according to the dosing criterion employed. METHODOLOGY: January 2015. Data on patient characteristics, disease and treatment were collected. As a result variables were collected: carboplatin dosing methods, dosage criteria, alternative dosing approaches, treatment delays, dose reductions, relative dose intensity, adverse reactions and severity (CTCAE v. 4.0) as well as overall survival and progressive free survival for major diagnoses. CONCLUSIONS: 1) Carboplatin dosing at the centre used Calvert's formula for calculating AUC and Cockcroft-Gault's formula for estimating glomerular filtration rate. 2) Cockcroft-Gault's formula employed actual body weight and ideal adjusted body weight in similar proportions. 3) The ideal adjusted body weight was more commonly used in patients with higher obesity and diabetes. 4) In the general population, the developmental trend of toxicity during treatment was greater in the group dosed by actual body weight, reaching significant differences in thrombopenia, neutropenia, GOT elevation, hyporexia and myalgias. 5) Major diagnoses in the present study were ovarian cancer and non-small cell lung cancer. The effectiveness in terms of overall survival and progression-free survival, comparing the groups dosed by actual body weight and ideal adjusted body weight within each pathology did not show statistically significant differences.
No takes yet. Share an insight, caveat, or question.
Ramírez-Roig et al. (2024) conducted an observational in Cancer requiring carboplatin in obese patients. Carboplatin dosing by actual body weight vs. Carboplatin dosing by ideal adjusted body weight was evaluated on Toxicity and effectiveness (overall survival and progression-free survival). Carboplatin dosing by actual body weight in obese patients was associated with significantly greater toxicity compared to ideal adjusted body weight, with no significant differences in survival.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: