PHARMACOKINETICS OF CARBOPLATIN IN A PATIENT WITH BOTH TESTICULAR CANCER AND HEMODIALYSIS-REQUIRING KIDNEY FAILURE

We report on a patient with advanced seminoma successfully treated with 4 cycles of carboplatin (80-100 mg/m2 per cycle) and etoposide (240-300 mg/m2) while being on hemodialysis 3 times weekly. Hemodialysis was performed on day 2 and day 3 of each chemotherapy cycle. Plasma platinum levels were determined at regular intervals at days 1, 2 and 3 of each cycle. The drug doses for cycle 2-4 were reduced due to grade 4 hematological toxicity during the preceding cycle. In spite of these drug reductions the AUC between 0-51 h remained unchanged for all cycles. Platinum was found in the plasma collected on day 1 of cycle 2-4 prior to start of the scheduled carboplatin infusion. The demonstrated pharmacokinetics of carboplatin (and probably also of etoposide) should be considered during chemotherapy of a testicular cancer patient on hemodialysis.