Carboplatin

合成路线和反应条件： 卡铂是通过顺铂与环丁烷-1,1-二羧酸在氨的存在下反应合成的 . 反应条件通常涉及将混合物加热以促进卡铂配合物的形成。

工业生产方法： 在工业环境中，卡铂是通过将顺铂溶解在水中并添加环丁烷-1,1-二羧酸和氨来生产的。 然后将混合物加热以促进反应，并通过结晶纯化得到的卡铂 .

反应类型： 卡铂会经历各种化学反应，包括取代反应。 一个值得注意的反应是它被氯离子激活，这会导致马来酸部分的去除并形成顺铂 .

常见试剂和条件：

氯离子： 用于激活卡铂并将其转化为顺铂.

酸性条件： 强酸性环境促进卡铂转化为顺铂.

主要形成的产物：

顺铂： 通过卡铂在酸性条件下被氯离子激活而形成.

卡铂具有广泛的科学研究应用：

化学： 用作模型化合物来研究铂类药物的行为及其与 DNA 的相互作用.

生物学： 研究其对细胞过程的影响及其诱导癌细胞凋亡的潜力.

医学： 广泛用于化疗方案中治疗各种癌症.

工业： 用于开发靶向药物递送系统，如脂质体，以提高其治疗效果并减少副作用.

卡铂通过形成反应性铂配合物来发挥作用，这些配合物会导致细胞内 DNA 分子的链内和链间交联 . 这种对 DNA 结构的修饰抑制 DNA 合成并影响细胞周期，最终导致细胞死亡 . 卡铂的分子靶点包括 DNA，它在 DNA 上形成共价键并破坏复制过程 .

类似化合物：

顺铂： 卡铂的前身，以其更高的毒性但类似的作用机制而闻名.

奥沙利铂： 另一种铂类化疗药物，具有不同的活性谱和毒性特征.

比较：

顺铂与卡铂： 卡铂的毒性低于顺铂，特别是在肾毒性和胃肠道副作用方面.

奥沙利铂与卡铂： 奥沙利铂具有不同的活性谱，通常用于治疗结直肠癌。

卡铂毒性降低而疗效相似，使其成为顺铂在化疗方案中的宝贵替代品，特别适用于无法耐受顺铂副作用的患者 .

Cisplatin: The predecessor of carboplatin, known for its higher toxicity but similar mechanism of action.

Oxaliplatin: Another platinum-based chemotherapy drug with a different spectrum of activity and toxicity profile.

Comparison:

Cisplatin vs. This compound: this compound is less toxic than cisplatin, particularly in terms of nephrotoxicity and gastrointestinal side effects.

Oxaliplatin vs. This compound: Oxaliplatin has a different spectrum of activity and is often used to treat colorectal cancer.

This compound’s reduced toxicity and similar efficacy make it a valuable alternative to cisplatin in chemotherapy regimens, particularly for patients who cannot tolerate the side effects of cisplatin .

Carboplatin, a platinum-based chemotherapeutic agent, is widely used in the treatment of various cancers, particularly ovarian and lung cancers. This article delves into its biological activity, mechanisms of action, efficacy in clinical settings, and associated toxicities, supported by data tables and case studies.

This compound exerts its anticancer effects primarily through the formation of DNA cross-links. Upon entering the cell, this compound undergoes hydrolysis to become positively charged, allowing it to bind covalently to nucleophilic sites on DNA, particularly the N7 position of guanine bases. This binding disrupts DNA replication and transcription, leading to apoptosis in cancer cells .

Key Mechanisms:

• DNA Cross-linking: Formation of DNA adducts that inhibit replication.
• Protein Interactions: this compound also interacts with RNA and proteins, contributing to its cytotoxic effects .
• Resistance Mechanisms: Cancer cells may develop resistance through various mechanisms, including increased drug efflux and enhanced DNA repair capabilities .

Efficacy in Clinical Trials

A significant body of research has evaluated the efficacy of this compound in clinical settings. A randomized clinical trial compared single-agent this compound with combination therapies involving paclitaxel. The results indicated that single-agent this compound had significantly worse survival outcomes compared to combination regimens in older patients with ovarian cancer .

Summary of Clinical Findings:

This trial underscores the importance of combination therapies in enhancing treatment efficacy while minimizing adverse effects.

Case Studies

In preclinical models, this compound has shown significant tumor growth inhibition. For instance, studies have demonstrated its effectiveness in subcutaneous lung cancer models, highlighting its potential as a first-line treatment option .

Notable Case Study:

• Patient Profile: An 80-year-old female with stage IV ovarian cancer.
• Treatment Regimen: this compound AUC 5 mg/mL·min + Paclitaxel.
• Outcome: The patient completed six cycles with manageable side effects but experienced disease progression post-treatment.

Toxicity and Side Effects

While this compound is effective against various tumors, it is associated with several toxicities. The most common adverse effects include:

• Hematological Toxicity: Neutropenia and thrombocytopenia are frequently observed.
• Neurotoxicity: this compound can cause peripheral neuropathy due to its effects on sensory neurons .
• Nausea and Vomiting: These are common side effects that can significantly impact patient quality of life.

Recent Research Findings

Recent studies have explored the enhancement of this compound's activity through various mechanisms. For example, research indicates that this compound enhances the activation of transient receptor potential ankyrin 1 (TRPA1) channels in sensory neurons, which may contribute to its neurotoxic effects but also suggests potential pathways for mitigating pain associated with chemotherapy-induced peripheral neuropathy (CIPN) .

Basic Research Questions

Q. How is Carboplatin dosage calculated based on renal function in clinical research, and what methodological considerations ensure accuracy?

this compound dosing relies on the Calvert formula: Dose (mg) = Target AUC × (GFR + 25) . This formula was derived from pharmacokinetic studies linking this compound plasma clearance to glomerular filtration rate (GFR) and validated prospectively across diverse patient cohorts . Key considerations include:

• GFR measurement : Use standardized methods (e.g., iohexol clearance or Cockcroft-Gault equation).
• Target AUC selection : Tailor to patient history (e.g., AUC 5 for pretreated patients; AUC 7 for untreated patients).
• Nonrenal clearance validation : Ensure body surface area does not influence nonrenal clearance, as demonstrated in pharmacokinetic modeling .

Q. What are the standard efficacy metrics for evaluating this compound in solid tumors, and how are they applied in clinical trials?

Efficacy is assessed using RECIST (Response Evaluation Criteria in Solid Tumors) guidelines, which standardize tumor measurement and response classification (e.g., complete/partial response, stable/progressive disease) . Key metrics include:

• Overall Survival (OS) : Median survival and hazard ratios.
• Progression-Free Survival (PFS) : Time to disease progression or death.
• Toxicity grading : Use CTCAE (Common Terminology Criteria for Adverse Events) to quantify hematological/non-hematological adverse effects. Example: In NSCLC trials, this compound-paclitaxel showed a median survival of 7.9 months, comparable to cisplatin-based regimens .

Q. How should researchers design experiments to compare this compound monotherapy with combination regimens?

• Randomization : Assign patients to monotherapy vs. combination arms to minimize bias .
• Endpoint selection : Prioritize PFS for early efficacy signals and OS for long-term outcomes.
• Sample size calculation : Use power analysis to detect clinically meaningful differences (e.g., 80% power, α = 0.05).
• Toxicity monitoring : Predefine thresholds for dose modification (e.g., grade 3 thrombocytopenia). Example: A phase II trial comparing this compound-paclitaxel with/without cetuximab required 108 patients to detect a hazard ratio of 0.70 .

Advanced Research Questions

Q. How can pharmacokinetic modeling address interpatient variability in this compound response?

Pharmacokinetic models (e.g., two-compartment models) integrate GFR, nonrenal clearance, and AUC to predict drug exposure. Methodological steps include:

• Plasma sampling : Collect serial post-infusion samples to estimate clearance rates.
• Nonlinear mixed-effects modeling : Use software like NONMEM to account for covariates (e.g., age, albumin levels).
• Validation : Compare predicted vs. observed AUC values (e.g., ±15% error margin) . Example: A refined Calvert formula reduced interpatient variability in AUC prediction from 24% to 11% in prospective studies .

Q. What statistical approaches resolve contradictions in this compound efficacy data across studies?

• Meta-analysis : Pool data from trials with homogeneous designs (e.g., fixed cisplatin-carboplatin ratios) to identify trends.
• Subgroup analysis : Stratify by biomarkers (e.g., ERCC1 expression) or patient characteristics (e.g., smoking status).
• Bayesian hierarchical models : Adjust for confounding variables (e.g., prior therapies, supportive care differences). Example: A meta-analysis of 1,207 NSCLC patients found no survival difference between this compound-paclitaxel and cisplatin-gemcitabine, despite divergent toxicity profiles .

Q. How can researchers predict synergistic effects of this compound in multidrug cocktails using limited experimental data?

The "pairs model" predicts synergy by testing drug pairs and extrapolating to higher-order combinations. Steps include:

• Dose-response matrices : Measure viability curves for individual drugs and pairs.
• Bliss independence or Loewe additivity : Quantify synergy/antagonism.
• Validation in vivo : Use xenograft models to confirm efficacy. Example: A study combining this compound with etoposide and camptothecin achieved 80% tumor reduction in vitro using this approach .

Q. What strategies ensure reproducibility in preclinical studies evaluating this compound resistance mechanisms?

• NIH guidelines compliance : Document cell line authentication, passage numbers, and assay conditions (e.g., hypoxia vs. normoxia) .
• Open data practices : Share raw data (e.g., RNA-seq files) via repositories like GEO or Figshare.
• Replication cohorts : Validate findings in independent cell lines or patient-derived organoids. Example: A study on this compound resistance in ovarian cancer required three independent replicates for all qPCR and Western blot results .

Q. Methodological Tables

Table 1. Key Parameters in the Calvert Formula

Table 2. Efficacy of this compound in Phase III NSCLC Trials