Dose optimisation of carboplatin in adults

Carboplatin haematological toxicities are clearly related to AUC. It seems likely that therapeutic efficacy is also related to AUC, although the maturation of clinical trials is necessary to establish this point. Using AUC-based dosing compensates for variations in renal function between and within individual patients. Since this variability is considerable, AUC-based dosing is a desirable practice. However, it does not allow for other factors such as previous chemotherapy, previous radiotherapy or performance status. Thus it does not remove the requirement for clinical judgements when managing a patient with cancer; it simply helps to remove one of the subjective elements of such judgements.