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Cisplatin vs. Carboplatin with Alimta & Keytruda


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When I last met with my oncologist (before molecular studies were back), he outlined three potential treatment protocols. If I had a targetable mutation (which, as I learned today, I don't), then we'd start with that. Absent a driver mutation, the two remaining protocols would be (1) Carboplatin/Alimta/Ketruda OR (2) Cisplatin/Alimta/Keytruda PLUS radiation to chest.

I met with the radiation oncologist, who thinks I'm a good candidate for radiation, which he would recommend to begin AFTER chemo is finished.

Does anyone know (and I'll ask my oncologist next week) why Cisplatin would be recommended for the treatment that includes radiation, as opposed to Carboplatin? (Or vice-versa.) From what I've been able to find online, it sounds as if Carboplatin and Cisplatin are similar in terms of effectiveness, but Cisplatin is considered more toxic. I'm just wondering why the addition of radiation into the treatment plan would affect which platinum-based chemo would be recommended.

Anyone have any idea?

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I just PM'd my former oncologist (who's now in Minneapolis) about this question (he's asked me to keep him updated and we're FB friends). He said Carboplatin can, when combined with radiation, lower blood counts. But maybe that's not the case when the radiation is done AFTER chemo (rather than at the same time)? Something to ask the oncologist next week, for sure.

 

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34 minutes ago, LexieCat said:

I just PM'd my former oncologist (who's now in Minneapolis) about this question (he's asked me to keep him updated and we're FB friends). He said Carboplatin can, when combined with radiation, lower blood counts. But maybe that's not the case when the radiation is done AFTER chemo (rather than at the same time)? Something to ask the oncologist next week, for sure.

 

My oncologist told me the same thing this morning when I asked about my blood count. I am not even on radiation. He said my blood count will bounce back up when he takes me off  carboplatin.

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From what I understand the Cisplatin/Altima/Keytruda/Radiation would be an aggressive treatment plan with potentially curative intent.  Sometimes there's only two doses of Cisplatin administered, while others call for four rounds.   I think of Cisplatin as a first line treatment, might have more side effects, the question I would ask the oncologist is what would be the most effective treatment plan.   Hit it hard for round one of treatment. Time to get the show on the road.  Carry on. 

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I just finished two rounds of cisplatin/alimta and then two carboplatin/alimta with no radiation.  Onc ended up switching to carboplatin because the cisplatin was causing tinnitus and some hearing loss.  

My blood counts were definitely much lower after the switch to the carbo, but not sure if it was the carboplatin or just the cumulative effects of four rounds of chemo.   

 

 

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