<oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
  <dc:creator>Fehr M</dc:creator>
  <dc:creator>Maranta AF</dc:creator>
  <dc:creator>Reichegger H</dc:creator>
  <dc:creator>Gillessen S</dc:creator>
  <dc:creator>Cathomas R</dc:creator>
  <dc:date>2018</dc:date>
  <dc:description xmlns:ns0="xml" ns0:lang="en">Introduction
The practice of carboplatin dosing is not concordant among different centres and oncologists. Some clinical guidelines recommend capping of the carboplatin dose at, for example, creatinine-clearance (Crea-Cl) of 125 mL/min because of concerns of excessive toxicity. Clinical data to support such recommendations are lacking, especially in patients with seminoma.


Methods
This is a retrospective analysis of acute haematotoxicity of patients with stage I seminoma treated with adjuvant carboplatin area under the curve (AUC) 7 in routine practice in two Swiss centres in 2005-2015, and a comparison of incidence and grade (according to Common Terminology Criteria for Adverse Events v4.0) of haematological adverse events (hAEs) in patients with Crea-Cl &lt;125 mL/min vs &gt;125 mL/min without dose capping.


Results
74 patients with 229 documented measurements were included (median 3/patient). A total of 151 hAEs occurred. Platelet nadir occurred earlier than median white cell/neutrophil count (median day 15 vs day 22; P&lt;0.0001). The majority of hAEs were mild, with more than 80% being of grade 1. Only two (2.7%) clinically relevant hAEs necessitating subsequent interventions occurred (one patient received platelet transfusion, one patient with febrile neutropaenia). Haematological toxicities were not statistically different in patients dosed with Crea-Cl &gt;125 mL/min versus those with Crea-Cl &lt;125 mL/min. No hAEs other than grade 1 occurred before day 10 and after day 24.


Conclusions
Toxicity after single-dose carboplatin AUC 7 is generally mild. No excess of toxicity occurs in patients with high Crea-Cl above 125 mL/min, and therefore dose capping is not routinely necessary. In addition, this study provides a rationale for efficient use of healthcare services without compromising patients' safety.</dc:description>
  <dc:format>application/pdf</dc:format>
  <dc:identifier>https://sonar.ch/global/documents/278321</dc:identifier>
  <dc:language>eng</dc:language>
  <dc:relation>info:eu-repo/semantics/altIdentifier/doi/10.1136/esmoopen-2018-000320</dc:relation>
  <dc:relation>info:eu-repo/semantics/altIdentifier/pmid/29531843</dc:relation>
  <dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
  <dc:source>ESMO open. - 2018</dc:source>
  <dc:subject xmlns:ns1="xml" ns1:lang="en">carboplatin</dc:subject>
  <dc:subject xmlns:ns2="xml" ns2:lang="en">creatinine clearance</dc:subject>
  <dc:subject xmlns:ns3="xml" ns3:lang="en">dose capping</dc:subject>
  <dc:subject xmlns:ns4="xml" ns4:lang="en">seminoma stage I</dc:subject>
  <dc:subject xmlns:ns5="xml" ns5:lang="en">toxicity</dc:subject>
  <dc:title xmlns:ns6="xml" ns6:lang="en">Carboplatin dose based on actual renal function: no excess of acute haematotoxicity in adjuvant treatment in seminoma stage I.</dc:title>
  <dc:type>http://purl.org/coar/resource_type/c_6501</dc:type>
</oai_dc:dc>
