carboplatin

Overview

Carboplatin is a platinum-based antineoplastic agent used in chemotherapy for a wide range of solid tumors. Like other platinum compounds, it exerts its anticancer effect primarily by forming DNA crosslinks, which interfere with DNA replication and transcription and ultimately promote cell death. Compared with cisplatin, carboplatin is generally considered less nephrotoxic and less emetogenic, although it remains associated with clinically important toxicities such as myelosuppression and hypersensitivity reactions.

In contemporary oncology, carboplatin is commonly used in combination regimens with agents such as paclitaxel, pemetrexed, gemcitabine, etoposide, and targeted or immune therapies including pembrolizumab, durvalumab, atezolizumab, amivantamab, and serplulimab. It is a standard backbone in treatment protocols for lung cancer, gynecologic malignancies, breast cancer, melanoma, and pediatric or rare tumors, and it also appears in veterinary oncology and experimental drug-delivery research.

Focus of Latest Publications

Recent publications investigate carboplatin across diverse therapeutic contexts, with the majority examining its use in combination with immunotherapies or targeted agents for non-small cell lung cancer. Phase III trials evaluated carboplatin-pemetrexed paired with checkpoint inhibitors, including atezolizumab (APPLE trial in nonsquamous disease), durvalumab (DUO-E trial in endometrial cancer), and the bispecific antibody amivantamab (ACROSS2 and PAPILLON trials in EGFR-mutated NSCLC with exon 20 insertions or concurrent tumor suppressor mutations). These regimens demonstrated clinically meaningful improvements in progression-free survival and response rates, though with varying tolerability. Carboplatin was also combined with serplulimab in a phase II neoadjuvant trial for resectable squamous NSCLC, and with pembrolizumab and paclitaxel in metastatic melanoma, with biomarker analyses revealing associations between peripheral immune signatures and clinical outcomes.

Neoadjuvant carboplatin-based chemotherapy continues to show promise across solid tumors. The combination of carboplatin, paclitaxel, and cetuximab (PCE) was evaluated as "bridging therapy" in locally advanced head and neck squamous cell carcinoma to prevent rapid tumor progression during preoperative periods. In resectable NSCLC, neoadjuvant atezolizumab combined with carboplatin and nab-paclitaxel achieved a 45% major pathologic response rate, including 25% complete pathological response, with all patients undergoing complete anatomical resection. Beyond pulmonary and head-and-neck malignancies, carboplatin with cabazitaxel and abiraterone was evaluated in high-volume metastatic castration-sensitive prostate cancer.

Unexpected neuroprotective activity emerged in preclinical and disease models of amyotrophic lateral sclerosis, where carboplatin alleviated transactive response DNA-binding protein (TDP)-43–induced astrocytic neurotoxicity by suppressing nuclear factor kappa B phosphorylation, restoring mitochondrial respiration and ATP production, and rescuing locomotor deficits in transgenic organisms without affecting TDP-43 protein levels. This finding suggests potential repurposing of carboplatin in TDP-43–associated proteinopathies. Simultaneously, multiple computational and materials science studies optimized carboplatin delivery through advanced platforms: magnesia-based carriers enabling synergistic drug activation and enhanced DNA-guanine targeting, functionalized calix[4]arene complexes responsive to external electric fields, and injectable modular microgels permitting temporally coordinated sequential release with other chemotherapeutics to overcome resistance.