Incidence and physiological mechanism of carboplatin-induced electrolyte abnormality among patients with non-small cell lung cancer

// Yushui Ma 1,2,* , Likun Hou 3,* , Fei Yu 1,* , Gaixia Lu 1 , Shanshan Qin 1 , Ruting Xie 4 , Huiqiong Yang 4 , Tingmiao Wu 1 , Pei Luo 1 , Li Chai 1 , Zhongwei Lv 1 , Xiaodong Peng 5 , Chunyan Wu 3 and Da Fu 6 1 Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China 2 Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, College of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China 4 Department of Pathology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China 5 Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China 6 Central Laboratory for Medical Research, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China * These authors have contributed equally to this work Correspondence to: Xiaodong Peng, email: // Chunyan Wu, email: // Da Fu, email: // Keywords : carboplatin; hyponatremia; hypokalemia; dehydration; FDA adverse event reporting system Received : May 01, 2016 Accepted : October 14, 2016 Published : October 21, 2016 Abstract To clarify the association between carboplatin and electrolyte abnormality, a pooled-analysis was performed with the adverse event reports of non-small cell lung cancer patients. A total of 19901 adverse events were retrieved from the FDA Adverse Event Reporting System (FAERS). Pooled reporting odds ratios (RORs) and 95% CIs suggested that carboplatin was significantly associated with hyponatremia (pooled ROR = 1.57, 95% CI 1.18–2.09, P = 1.99×10 -3 ) and hypokalemia (pooled ROR = 2.37, 95% CI 1.80–3.10, P = 5.24×10 -10 ) as compared to other therapies. In addition, we found that dehydration was frequently concurrent with carboplatin therapy (pooled ROR = 2.01, 95% CI 1.52–2.66, P = 8.37×10 -7 ), which may prompt excessive water ingestion and decrease serum electrolyte concentrations. This information has not been mentioned in the FDA-approved drug label and could help explain the physiological mechanism of carboplatin-induced electrolyte abnormality. In conclusion, the above results will facilitate clinical management and prompt intervention of life-threatening electrolyte imbalance in the course of cancer treatment.