Regimen for Advanced or Recurrent Endometrial Carcinoma: Paclitaxel + Carboplatin (TC)
Sorbe B et al. Int J Gynecol Cancer 2008;18:803–808
Premedication for paclitaxel:
Dexamethasone 20 mg per dose; administer orally or intravenously in 10–50 mL 0.9% sodium chloride injection (0.9% NS) or 5% dextrose injection (D5W) for 2 doses, 12–14 hours and 6–7 hours before starting paclitaxel
Diphenhydramine 50 mg, by intravenous injection 30 minutes before starting paclitaxel
Ranitidine 50 mg; administer intravenously over 30–60 minutes, 30 minutes before starting paclitaxel
Paclitaxel 175 mg/m2; administer intravenously in a volume of 0.9% NS or D5W sufficient to produce a solution with concentration within the range 0.3–1.2 mg/mL over 3 hours on day 1 every 3 weeks (total dosage/cycle = 175 mg/m2)
Carboplatin✫ AUC = 5 mg/mL · min; administer intravenously in 50–150 mL D5W over 60 minutes, on day 1, every 3 weeks (total dosage/cycle calculated to produce an AUC = 6 mg/mL · min) (see equation below)

In practice, creatinine clearance (Clcr) is used in place of glomerular filtration rate (GFR). Clcr can be calculated from the equation of Cockcroft and Gault:


Note: On October 8, 2010, the U.S. Food and Drug Administration (FDA) identified a potential safety issue with carboplatin dosing based on recent changes in the measurement of serum creatinine. By the end of 2010, all clinical laboratories in the USA will use the standardized Isotope Dilution Mass Spectrometry (IDMS) method to measure serum creatinine, which could result in an overestimation of the GFR in some patients with normal renal function. A carboplatin dose calculated with an IDMS-measured serum creatinine result using the Calvert formula could exceed an expected exposure (AUC) and result in increased drug-related toxicity
Provided actual GFR measurements are made to assess renal function, carboplatin can be safely dosed according to the Calvert formula described in product labeling
If GFR (or creatinine clearance) is estimated based on serum creatinine measurements by the IDMS method, the FDA recommended for patients with normal renal function capping an estimated GFR at 125 mL/min for any targeted AUC value. No greater estimated GFR values should be used
U.S. FDA. Carboplatin dosing. [online] May 23, 2013. Available from: http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm228974.htm [accessed February 26, 2014]
Calvert AH et al. J Clin Oncol 1989;7:1748–1756
Cockcroft DW, Gault MH. Nephron 1976;16:31–41
Jodrell DI et al. J Clin Oncol 1992;10:520–528
Sorensen BT et al. Cancer Chemother Pharmacol 1991;28:397–401
Supportive Care
Antiemetic prophylaxis
Emetogenic potential: HIGH. Potential for delayed symptoms
See Chapter 39 for antiemetic recommendations
Hematopoietic growth factor (CSF) prophylaxis
Primary prophylaxis may be indicated
See Chapter 43 for more information
Antimicrobial prophylaxis
Risk of fever and neutropenia is LOW
Antimicrobial primary prophylaxis to be considered:
See Chapter 47 for more information
Patient Population Studied
A prospective, phase II, multicenter study evaluating carboplatin and paclitaxel in the treatment of patients with primary advanced or recurrent endometrial carcinoma. Sixty-six patients were enrolled: 18 with primary advanced tumors and 48 with recurrences. All histologic types and tumor grades were allowed