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Carboplatin
- Mechanism: exact unknown, but may form DNA cross links. (DNA alkylator)
- Dose 300-400 mg/m2. q4 weeks
- Renally excreted
- Primary toxicity: Thrombocytopenia, leukopenia, nausea, vomitting.
- Secondary toxicity: Renal, peripheral neuropathy
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Cisplatin
- Mech: Formation of intra-structural DNA cross links
- Dose: 50-120 mg/m2 q3-4 weeks
- Elimination 90% renal, 10% billary
- Toxicity: primary - Leukopenia, anemia, renal, ototoxicity, peripheral neuropathy
- secondary: decreased levels of Na, K, Ca and Mg, anaphylactoid reactions
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Ifosfamide
- Uses: Sarcoma, ovarian and cervical cancer
- Mechanism: DNA cross links
- Dose: 1.2 gm/m2/day for 5 days, q21-28 days
- Renal excretion, required hepatic metabolism to become active
- Toxicity:
- Primary: Hemorrhagic cystitis (acrolein), myelosupression, N/V, alopecia
- Secondary: Nephrotoxicity, CNS toxicity, SIADH
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Bleomysin
- Antibiotic, complexes w/ Fe to form oxidase and in turn free radicals which results in DNA strand breaks w/ cells most suseptible in the G2 and mitotic phases. Therefore is cell cycle specific.
- Dose: 10 mg/m2/day for 4 days, q4wks
- Renal excretion
- 1 - Fever, interstitial pneumonitis (10%), pulm fibrosis (1%), stomatitis. Keep dose < 400 u as pulm fibrosis occurs above this level. A 30-35% change in DLCO - d/c
- 2- n/v myelosupression
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