Key points
- Carboplatin is a chemotherapy drug from the platinum family that damages the DNA of cancer cells [1].
- It is widely used for ovarian cancer and, with paclitaxel, for lung, breast, oesophageal and cervical cancer [1, 2, 3, 4, 5, 6].
- Its dose is worked out from kidney function, so a blood test is needed before every cycle [1, 7].
- The main side effect is low blood counts, especially platelets, which reach their lowest point about three weeks after the infusion [1].
- Compared with cisplatin, it causes less nausea and nerve damage and usually does not need large amounts of IV fluids [1].
- An allergic reaction can happen a few minutes after the infusion starts, especially in people who have had a platinum drug before [1].
What is this drug and how does it work?
For physicians
Carboplatin is a platinum compound that, like cisplatin, mainly forms interstrand DNA cross-links, and its effect is not cell-cycle specific [1]. Carboplatin is converted to its active form (aquation) more slowly than cisplatin; even so, both drugs produce similar numbers of drug–DNA cross-links and equivalent biological effects, and their difference in potency reflects this difference in aquation rate [1].
Carboplatin is not bound to plasma proteins and is eliminated mainly by the kidneys: in patients with a creatinine clearance of about 60 mL/min or more, 65% of the dose is excreted in the urine within 12 hours and 71% within 24 hours [1]. Clearance therefore depends directly on the glomerular filtration rate (GFR), and dosing by kidney function gives more predictable exposure [1, 7].
Which cancers is it used for?
Your doctor may prescribe this drug for:
- Ovarian cancer (first treatment)
- Ovarian cancer that has come back
- Non-small cell lung cancer
- Triple-negative breast cancer (stages II and III)
- Cancer of the oesophagus and the junction with the stomach
- Cervical cancer (locally advanced)
Whether it suits you depends on the type and stage of your cancer and your test results. Details of each use are in the section for doctors.
For physicians
| Cancer | Setting |
|---|---|
| Ovarian cancer (initial treatment) | Advanced disease, in combination with other chemotherapy drugs (FDA-labelled indication); nowadays usually with paclitaxel |
| Recurrent ovarian cancer | Palliative treatment after prior chemotherapy, including in patients previously treated with cisplatin (FDA-labelled indication) |
| Non-small cell lung cancer | Advanced disease; a platinum-based doublet, alone or with immunotherapy |
| Triple-negative breast cancer (stages II and III) | Neoadjuvant treatment with paclitaxel and pembrolizumab |
| Oesophageal and gastro-oesophageal junction cancer | Preoperative chemoradiotherapy (CROSS regimen) |
| Cervical cancer (locally advanced) | Short induction chemotherapy before chemoradiotherapy |
The only official FDA-labelled indication is advanced ovarian cancer; other uses are based on randomised trials and clinical guidelines [1].
| Cancer | Key evidence |
|---|---|
| Ovarian cancer (initial treatment) | In two NCIC and SWOG trials with 789 patients, carboplatin and cisplatin (both with cyclophosphamide) gave equivalent overall survival [1]. In GOG-158, carboplatin + paclitaxel was less toxic than and non-inferior to cisplatin + paclitaxel (median overall survival 57.4 vs 48.7 months) [2]. In ICON7, adding bevacizumab to carboplatin–paclitaxel improved progression-free survival (HR 0.81) [8] |
| Recurrent ovarian cancer | In patients who progressed during cisplatin treatment, response rates may be lower [1] |
| Non-small cell lung cancer | In an ECOG trial with 1207 patients, carboplatin + paclitaxel did not differ significantly from cisplatin + paclitaxel in response or survival [3]. In KEYNOTE-189, pembrolizumab with pemetrexed and carboplatin or cisplatin raised 5-year overall survival from 11.3% to 19.4% [9] |
| Triple-negative breast cancer (stages II and III) | In KEYNOTE-522, pathological complete response with pembrolizumab added to paclitaxel–carboplatin was 64.8% vs 51.2% [4] |
| Oesophageal and gastro-oesophageal junction cancer | In CROSS, weekly carboplatin (AUC 2) + weekly paclitaxel (50 mg/m²) for 5 weeks with 41.4 Gy radiotherapy, followed by surgery, raised median overall survival from 24.0 to 49.4 months [5] |
| Cervical cancer (locally advanced) | In INTERLACE, 6 weeks of weekly carboplatin (AUC 2) + paclitaxel (80 mg/m²) before cisplatin chemoradiotherapy raised 5-year overall survival from 72% to 80% (HR 0.60) [6] |
How it is taken and dosing
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Treatment regimens and doses: index5 regimens
Carboplatin is given only by experienced healthcare staff, as an intravenous infusion (drip) that usually lasts 15 minutes or more [1]. Your doctor works out your dose from your height, weight and especially your kidney function; the drug may be given alone or with other drugs and, in the standard regimens of the label, is usually repeated every 4 weeks [1]. In some regimens (such as CROSS or INTERLACE), carboplatin is given at a lower dose every week [5, 6].
Unlike cisplatin, large amounts of IV fluids before and after the infusion are usually not needed [1]. A blood test is done before every cycle, and if the neutrophil or platelet count has not yet recovered, the next dose is postponed [1]. Take the anti-sickness medicines you have been prescribed as planned [1]. Never skip or move a treatment appointment on your own.
- Calvert formula: total dose (mg) = target AUC × (GFR + 25); the result is in mg, not mg/m². In previously treated patients, a target AUC of 4 to 6 is the most appropriate range for single-agent carboplatin; grade 3–4 thrombocytopenia occurred in 16% with AUC 4 to 5 and in 33% with AUC 6 to 7 [1]. Calvert proposed a target AUC of 5 for previously treated and 7 for untreated patients (single agent); the target AUC in combination regimens is set separately [7].
- GFR cap: since 2010, NCI/CTEP in agreement with the FDA has recommended that when GFR is estimated from serum creatinine (measured with the standardised IDMS method), an estimated GFR above 125 mL/min should not be used in the Calvert formula [10, 11]; the maximum doses for AUC 6, 5 and 4 are therefore 900, 750 and 600 mg [10]. Reason: with normal renal function, the IDMS method reports creatinine on average 10 to 20% lower than older methods, raising the estimated GFR and therefore the dose above what is intended [10].
- Renal impairment (day 1 dose with mg/m² dosing): CLcr 41 to 59 mL/min: 250 mg/m²; 16 to 40: 200 mg/m²; below 15: insufficient data for a recommendation. Later doses according to myelosuppression [1].
- Adjustment by the nadir counts of the previous cycle: platelets above 100,000 / neutrophils above 2000: 125%; platelets 50,000 to 100,000 / neutrophils 500 to 2000: no change; platelets below 50,000 / neutrophils below 500: 75% (in trials, reduced to 50 to 60% for severe myelosuppression) (with cyclophosphamide, for both drugs). Increases above 125% were not recommended [1].
- Condition for repeating a cycle: neutrophils ≥2000 and platelets ≥100,000 per µL [1].
- Administration: infusion over 15 minutes or more; no hydration or forced diuresis needed; may be diluted to 0.5 mg/mL in 5% dextrose or 0.9% sodium chloride; do not use needles or sets containing aluminium. Antiemetic premedication [1].
- Monitoring: frequent blood counts until recovery; anaemia is cumulative. The risk of hypersensitivity (anaphylaxis within minutes of starting) is higher with prior platinum exposure. Caution with aminoglycosides and nephrotoxic or ototoxic drugs [1].
For physicians
Standard dosing and combination regimens
Single-agent carboplatin (FDA label)
Recurrent ovarian cancer after prior chemotherapy (including cisplatin)Cycle length: Every 4 weeks
Recurrent ovarian cancer after prior chemotherapy (including cisplatin)
Before prescribing: Prescribing notes| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Carboplatin | 360 mg/m²; or by the Calvert formula (target AUC 4 to 6 in previously treated patients) | IV, over 15 minutes or more | Day 1 |
Dosing as per the FDA label [1].
Carboplatin + cyclophosphamide (FDA label)
Initial treatment of advanced ovarian cancerCycle length: Every 4 weeks
Initial treatment of advanced ovarian cancer
Before prescribing: Prescribing notes| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Carboplatin | 300 mg/m² (or formula dosing) | IV, over 15 minutes or more | Day 1 |
| Cyclophosphamide | 600 mg/m² | IV | Day 1 |
Today, initial treatment of ovarian cancer usually uses the combination with paclitaxel (next row) [2].
Evidence: GOG-158 (2003)
Carboplatin + paclitaxel every 3 weeks (ICON7 trial)
Initial treatment of ovarian cancer (common use outside the label wording)Cycle length: Every 21 days
Initial treatment of ovarian cancer (common use outside the label wording)
Before prescribing: Prescribing notes| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Carboplatin | AUC 5 or 6 (Calvert formula) | IV | Day 1 |
| Paclitaxel | 175 mg/m² | IV | Day 1 |
Doses from the ICON7 control arm [8].
Evidence: ICON7 (2011)
CROSS: weekly carboplatin + paclitaxel with radiotherapy
Oesophageal or junctional cancer, preoperative chemoradiotherapy (off-label use)Cycle length: Weekly
Oesophageal or junctional cancer, preoperative chemoradiotherapy (off-label use)
Before prescribing: Prescribing notes| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Carboplatin | AUC 2 | IV | Weekly |
| Paclitaxel | 50 mg/m² | IV | Weekly |
| Radiotherapy | 41.4 Gy in 23 fractions | 5 days a week |
Doses from the CROSS trial [5].
Evidence: CROSS (2012)
INTERLACE: short induction with carboplatin + paclitaxel
Locally advanced cervical cancer, before cisplatin chemoradiotherapy (off-label use)Cycle length: Weekly
Locally advanced cervical cancer, before cisplatin chemoradiotherapy (off-label use)
Before prescribing: Prescribing notes| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Induction | |||
| Carboplatin | AUC 2 | IV | Weekly |
| Paclitaxel | 80 mg/m² | IV | Weekly |
| Then | |||
| Cisplatin + radiotherapy | 40 mg/m² weekly, 5 weeks | IV | |
Doses from the INTERLACE trial [6].
Evidence: INTERLACE (GCIG) (2024)
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Side effects
The most common side effects:
- Nausea and vomiting, usually in the first 24 hours; an anti-sickness medicine is given before the infusion [1].
- Anaemia (tiredness, paleness); sometimes a blood transfusion is needed [1].
- Low platelets and white blood cells, which show up in blood tests [1].
- Low blood salts (magnesium, sodium, potassium), which usually cause no symptoms [1].
- Abdominal pain, diarrhoea or constipation; numbness of the hands and feet and hair loss are less common than with most chemotherapy [1].
For physicians
The figures below come from the FDA label and are based on 1893 patients with various tumours who received carboplatin as a single agent; figures in brackets are for previously treated patients with ovarian cancer [1]. In combination regimens some adverse reactions are more frequent.
| Adverse reaction | Frequency |
|---|---|
| Vomiting | 65% (81%); severe in about a third of these patients; nausea without vomiting in another 10 to 15%; usually resolves within 24 hours [1] |
| Anaemia (haemoglobin below 11) | 71% of patients starting with a higher haemoglobin; transfusion needed in 26% (44%) [1] |
| Thrombocytopenia (below 50,000) | 25% (35%) [1] |
| Neutropenia (below 1000) | 16% (21%) [1] |
| Electrolyte decreases | Sodium 29%, potassium 20%, calcium 22% and magnesium 29%; rarely symptomatic [1] |
| Raised liver tests | Alkaline phosphatase 24%, AST 15%, bilirubin 5%; usually mild [1] |
| Abdominal pain, diarrhoea and constipation | Pain 17%, diarrhoea 6%, constipation 6% [1] |
| Peripheral neuropathy | 4% (6%); about 10% in people over 65 or with prior cisplatin [1] |
| Hypersensitivity reaction | 2% (rash, urticaria, erythema and pruritus; rarely bronchospasm and hypotension) [1] |
| Alopecia | 3% with carboplatin alone; 49% with cyclophosphamide [1] |
Serious side effects
These are less common but serious; tell your team early if you notice any sign of them:
- Infection or bleeding because of low blood counts: a temperature of 38 °C, chills, bruising or bleeding [1].
- An allergic reaction a few minutes after the infusion starts: itching, hives, shortness of breath or dizziness; more common in people who have had a platinum drug before. Tell the nurse straight away [1].
- Loss of hearing or vision, mostly with high doses or with other drugs [1].
For physicians
Boxed warning: bone marrow suppression is dose-related and may be severe, resulting in infection or bleeding; anaemia may be cumulative and require transfusion; vomiting is a frequent adverse reaction; and anaphylactic-like reactions may occur within minutes of administration [1].
- Bone marrow suppression: the dose-limiting toxicity; infectious or haemorrhagic complications were reported in 5% of patients and drug-related death in less than 1%. Myelosuppression is more severe in previously treated patients (especially with cisplatin), renal impairment, poor performance status, and in combination with other myelosuppressive drugs or radiotherapy [1].
- Hypersensitivity and anaphylaxis: the risk is higher in patients previously exposed to platinum [1].
- Hearing and kidneys: carboplatin has limited nephrotoxic potential, but concomitant aminoglycosides have increased renal and ototoxicity; clinically significant hearing loss has been reported in children given higher than recommended doses with other ototoxic drugs [1].
- Vision: visual loss (sometimes complete) has been reported with higher than recommended doses, usually recovering within weeks of stopping these doses [1].
- Liver: very high doses (more than 4 times the recommended dose) have been associated with severe liver test abnormalities [1].
- Other: secondary malignancies with multi-drug therapy, haemolytic uraemic syndrome (rare) and necrosis from extravasation have been reported [1].
Contraindications: a history of severe allergy to cisplatin or other platinum compounds, and severe bone marrow suppression or significant bleeding [1].
When should I call my doctor?
Contact your treatment team or go to the emergency department straight away if you have [1]:
- A temperature of 38 °C or higher, chills or any sign of infection
- Bleeding from the gums or nose, bruising or tiny red spots on the skin, bloody or black urine or stools
- A rash, itching, swelling of the face or lips, shortness of breath or feeling faint during or after the infusion
- Persistent vomiting that stops you drinking fluids
- Severe tiredness, paleness or shortness of breath on exertion (possible anaemia)
- Tingling or numbness of the hands and feet, loss of hearing or a change in vision
- Pain, swelling or redness at the infusion site
Interactions, pregnancy and precautions
- Other medicines: carboplatin may increase the effect of drugs that harm the kidneys, and use with aminoglycoside antibiotics increases the risk of kidney and hearing damage; give your doctor a full list of your medicines [1].
- Pregnancy: carboplatin may harm an unborn baby; women who could become pregnant should avoid pregnancy during treatment [1]. Ask your doctor which contraception to use and for how long after treatment.
- Breastfeeding: stopping breastfeeding during carboplatin treatment is recommended [1].
- Blood tests: blood counts are checked regularly; blood cells and platelets reach their lowest point about 3 weeks after the infusion and in most patients recover by the fourth week [1].
- Kidney function: because the dose is based on kidney function, the creatinine test before treatment matters; in about one in 4 patients kidney function falls slightly during treatment [1].
- Older adults: they are more likely to have a severe fall in platelets, and dosing with a GFR-based formula is recommended [1].
Frequently asked questions
Why is the carboplatin dose worked out from a kidney test?
Is carboplatin or cisplatin better?
It depends on the type of cancer. In advanced ovarian cancer, carboplatin + paclitaxel caused fewer side effects, was easier to give and worked as well as cisplatin + paclitaxel, although low platelets were more common with carboplatin [2]. In other cancers, your doctor chooses between them based on the evidence for that disease and on your kidney function, hearing and nerves.
What does an allergy to carboplatin look like?
It shows as a rash, hives, redness and itching, and rarely shortness of breath and low blood pressure, which can happen a few minutes after the infusion starts. The risk is higher in people who have had a platinum drug before, and these reactions have been controlled with standard treatment (adrenaline, steroids and antihistamines) [1]. Tell the nurse straight away about any unusual symptom during the infusion.
Will carboplatin make my hair fall out?
With carboplatin alone, hair loss is uncommon, but with other drugs it is much more common; for example, with cyclophosphamide about half of patients lost hair [1]. The partner drug (such as paclitaxel) plays a big part in hair loss.
When am I most at risk of infection?
With single-agent carboplatin, blood counts usually reach their lowest point around day 21 [1]. Watch more closely for signs of infection and bleeding at this time, and call straight away if you have a fever.
Scientific evidence
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Key studies
14 itemsA phase 3 trial of bevacizumab in ovarian cancer
Preoperative chemoradiotherapy for esophageal or junctional cancer
Perioperative Chemotherapy or Preoperative Chemoradiotherapy in Esophageal Cancer
Induction chemotherapy followed by standard chemoradiotherapy versus standard chemoradiotherapy alone in patients with locally advanced cervical cancer (GCIG INTERLACE): an international, multicentre, randomised phase 3 trial
Pembrolizumab Plus Pemetrexed and Platinum in Nonsquamous Non–Small-Cell Lung Cancer: 5-Year Outcomes From the Phase 3 KEYNOTE-189 Study
Overall Survival with Neoadjuvant Nivolumab plus Chemotherapy in Lung Cancer
Cervical Cancer, Version 2.2026, NCCN Clinical Practice Guidelines In Oncology
Atezolizumab plus bevacizumab and chemotherapy for metastatic, persistent, or recurrent cervical cancer (BEATcc): a randomised, open-label, phase 3 trial
Ivonescimab plus chemotherapy versus tislelizumab plus chemotherapy in advanced squamous non-small-cell lung cancer (HARMONi-6): interim overall survival analysis of a randomised, double-blind, phase 3 trial in China
Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non–Small-Cell Lung Cancer
Durvalumab after Chemoradiotherapy in Limited-Stage Small-Cell Lung Cancer
Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer
Pembrolizumab for Early Triple-Negative Breast Cancer
Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-048): a randomised, open-label, phase 3 study
Related cancer types
Treatment regimens (physicians)
References
11 referencesShow all references, 8 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2
- 3Comparison of Four Chemotherapy Regimens for Advanced Non–Small-Cell Lung Cancer
- 4Pembrolizumab for Early Triple-Negative Breast Cancer
- 5
- 6
- 7
- 8A Phase 3 Trial of Bevacizumab in Ovarian Cancer
- 9Pembrolizumab Plus Pemetrexed and Platinum in Nonsquamous Non–Small-Cell Lung Cancer: 5-Year Outcomes From the Phase 3 KEYNOTE-189 Study
- 10
- 11Analysis of carboplatin dosing in patients with a glomerular filtration rate greater than 125 mL/min: To cap or not to cap? A retrospective analysis and review
This page is based on reputable scientific sources and was last updated on 27 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
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