PHARMACOKINETICS OF CARBOPLATIN IN A PATIENT SUFFERING FROM ADVANCED OVARIAN-CARCINOMA WITH HEMODIALYSIS-DEPENDENT PENAL INSUFFICIENCY

Pharmacokinetics of carboplatin were determined in a patient suffering from advanced ovarian cancer with total hemodialysis-dependent chroni c renal failure undergoing 3 consecutive cycles of chemotherapy. Dosag e was adjusted to reach active AUC (area under the plasma concentratio n versus time curve) of ultrafilterable carboplatin. A hemodialysis, p erformed 24 h after administration, results in a decrease of 20% of ul trafilterable carboplatin AUC. The relative dialysis efficacy of ultra filterable carboplatin was great: 84+/-3%. The chemotherapy regimen co nsisted of carboplatin-cyclophosphamide combination for 6 cycles every 4 weeks. After treatment completion, the patient showed a complete re sponse and remains disease free 16 months after the end of the treatme nt. Carboplatin-based chemotherapy can be given to patients undergoing chronic hemodialysis without life-threatening toxicity with a dialysi s performed 24 h after the administration and with a dose adjustment o f carboplatin to reach a AUC of 6 mg/ml.min for untreated patients. In these conditions, response in platinum-sensitive tumors can be obtain ed.