Re: Prediction of Carboplatin Clearance From Standard Morphological and Biological Patient Characteristics

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Carboplatin is unique among antineoplastic agents in that the systemic drug exposure produced by any dose of drug in a given patient can be reasonably estimated on the basis of that patient's renal function ( 1 , 2 ) . The method of Calvert et al. ( 1 ) of delivering a desired carboplatin area under the time- concentration curve (AUC) has been widely used either with measured glomerular filtration rate (GFR) or creatinine clearance or with an estimated creatinine clearance calculated from the serum creatinine level by use of the Cockcroft-Gault equation ( 2 ) . More recently, Chatelut et al. ( 3 , 4 ) have developed a predictive model for the totalbody clearance of carboplatin in order to deliver a desired AUC of carboplatin. In their study, Chatelut et al. showed the correlation coefficient between the carboplatin clearance, as predicted by their model ( 3 ) , and GFR + 25 (the equation of Calvert et al.) to be 0.9. Furthermore, they illustrated that estimation of GFR by use of the Cockcroft-Gault equation underestimates carboplatin clearance. However, as detailed below, the Cockcroft- Gault equation will essentially always yield lower estimates of carboplatin clearance when compared with estimates obtained by the equation of Chatelut et al.