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Treatment Name: Carboplatin + Abraxane® (Paclitaxel protein-bound particles)

Carboplatin + Abraxane® (Paclitaxel protein-bound particles) is a Chemotherapy Regimen for Lung Cancer, Non-Small Cell Lung Cancer (NSCLC)

How does Carboplatin + Abraxane® work?
Carboplatin and Abraxane® are designed to kill cancer cells or slow growth of lung cancer cells.

Other names for Abraxane®:
     • albumin-bound paclitaxel
     • nab-paclitaxel

Goals of therapy:
Carboplatin + Abraxane® is given to shrink tumors and alleviate symptoms of lung cancer. This drug combination is not usually given with the goal of cure.

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Schedule

  • Carboplatin intravenous (I.V.) infusion given over 30 minutes on Day 1
  • Abraxane® I.V. infusion given over 30 minutes on Days 1, 8, and 15

Estimated total infusion time for this treatment:

  • Up to 2½ hours on Day 1, then up to 1½ hours on Days 8 and 15
  • Infusion times are based on clinical studies, but may vary depending on doctor preference or patient tolerability. Pre-medications and intravenous (I.V.) fluids, such as hydration, may add more time

Carboplatin and Abraxane® are usually given in an outpatient infusion center, allowing the person to go home afterwards. The schedule above is repeated every 21 days and this is known as one Cycle. Each cycle may be repeated until the drug stops working or until unacceptable side effects occur. Duration of therapy depends upon response, tolerability, and number of cycles prescribed.

Click here for common Carboplatin + Abraxane® starting doses.

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Side Effects

In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported side effects with Carboplatin + Abraxane® are shown here:

On average, 12% of patients discontinue treatment due to unacceptable side effects.

Side effect videos Side Effect Videos
AnemiaAnemiaBleedingBleedingFatigue Fatigue PainPainNausea and VomitingNausea and Vomiting

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Monitoring

How often is monitoring needed?
Labs (blood tests) may be checked before each treatment. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), plus any others the doctor may order.

How often is imaging needed?

Imaging may be checked before treatment and include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.  Imaging is often done again after several cycles to look for changes.

How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue Carboplatin + Abraxane® as planned, reduce the dose of future treatments, delay the next dose until the side effect goes away, or switch to an alternative therapy.

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ChemoExperts Tips

  • Carboplatin hypersensitivity reactions can be severe. This reaction is most common after 8 or 9 cycles, but can happen after any dose. Some institutions may use "desensitization protocols" to allow a person to keep receiving carboplatin after they have had a reaction. Desensitization is used if someone is receiving a good response from carboplatin, or if few other chemotherapy options are available
  • Patients and their caregivers should be counseled to recognize the signs and symptoms of drug reactions and know to report them immediately, even after they have left the clinic
  • Abraxane comes from the manufacturer as a powder for reconstitution and can take 20 to 30 minutes to fully dissolve (reconstitute) before loading into the I.V. bag. Plan on extra wait time if the infusion center pharmacy is busy on the day of treatment
  • A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
  • Clinical trials may exist for non-small cell lung cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications.

Patient Assistance & Co-payment Coverage

Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Carboplatin + Abraxane® (Paclitaxel protein-bound particles), we have provided links that may help.

Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Carboplatin + Abraxane® (Paclitaxel protein-bound particles). Depending upon your income, they may be able to help cover the cost of:

  • Carboplatin
  • Pacli­taxel protein-bound

For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.

  • If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.

Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Carboplatin + Abraxane® (Paclitaxel protein-bound particles) and are the best source to help you understand drug cost.

  • Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.

Emotional Wellness

What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.

Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.

Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.

Learn more about pursuing emotional wellness while receiving treatment with Carboplatin + Abraxane® (Paclitaxel protein-bound particles)

Individual Drug Label Information

Carboplatin (Paraplatin®)

  • Carboplatin is an intravenous infusion 
  • This medication is dosed based on your kidney function. If your kidney function improves or worsens during therapy, your dose may need to be adjusted
  • This drug should not be used during pregnancy, it may cause fetal harm
General Carboplatin (Paraplatin) Side Effects:  
  • Low red blood cells, low white blood cells, and most commonly, low platelets can be occur
  • Nausea and vomiting is common but can be prevented by taking certain pre-medications
  • Hair loss
  • Constipation and/or diarrhea
  • Pain
  • Allergic reactions to carboplatin can occur. These typically are not seen until after the 6th dose of carboplatin is given 
  • Can cause liver damage at high doses 
  • May cause kidney damage or hearing loss if combined with other medications that also cause these side effects 
  • Click on the carboplatin (Paraplatin) package insert below for reported side effects and possible drug interactions

Side Effect Videos
Nausea and VomitingNausea and VomitingDiarrheaDiarrheaHair LossHair LossBleedingBleedingConstipationConstipationPainPainAnemiaAnemia

See DailyMed package insert.

Pacli­taxel protein-bound (Abraxane®)

  • Abraxane is an intravenous infusion
  • Extreme caution is advised when this is given to patients with low white blood cells, known as neutrophils, are below a certain level.  Blood counts are usually checked before each infusion
  • Dosage adjustments may be required for liver dysfunction, low white blood cells, low platelets, nerve damage, or poor liver function
  • May interact with certain antifungal and seizure medications. Ask your doctor or pharmacist to review your medications for any possible interactions
  • May interact with grapefruit and grapefruit juice. This could increase your risk of experiencing side effects. Avoid eating grapefruit and drinking anything containing grapefruit juice during treatment
  • Although rare, can cause serious lung injury or shortness of breath
  • Known to cause fetal harm; this drug should be avoided during pregnancy
General Abraxane (paclitaxel protein bound particles) Side Effects
  • Low white blood cells
  • Infections due to low white blood cells may occur
  • Fever
  • Low blood platelets
  • Bleeding
  • Allergic reactions can occur
  • Pins and needles or a tingling feeling in the fingers and toes. This is reversible if caught early; notify doctor if this happens
  • Liver damage
  • Lung injury
  • Hair loss (minimal)
  • Fatigue
  • Nause and vomiting (minimized with pre-medication)
  • Diarrhea
  • Anemia
  • Click on the Abraxane® (paclitaxel protein-bound particles) package insert below for all reported side effects and possible drug interactions

Side Effect Videos
Nausea and VomitingNausea and VomitingDiarrheaDiarrheaHair LossHair LossFatigue Fatigue BleedingBleedingPainPainAnemiaAnemiaNeutropenic FeverNeutropenic Fever

See DailyMed package insert.

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References

Socinski MA, Bondarenko I, Karaseva NA, et al. Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced non–small-cell lung cancer: final results of a phase III trial. J Clin Oncol. 2012;30:2055-2062.

Created: September 25, 2016 Updated: October 5, 2018

What is Lung Cancer, Non-Small Cell Lung Cancer (NSCLC)?

What is Non-Small Cell Lung Cancer?
A disease of the tissue found in the lung.  Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Known causes include smoking and exposure to environmental toxins.  The stage of NSCLC can vary at diagnosis and throughout treatment.  Stages include stage I, II, III, and IV.  The effectiveness of the treatment may depend upon the stage at diagnosis.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.

What does "Cure" mean?

The word “cure” means there are no cancer cells left in the body and cancer will never come back. Depending on the cancer type and stage, this may be the true goal of therapy. However, it is very difficult to prove all cancer cells are gone. Even though images, like X-rays and MRI’s, and blood tests may not show any signs of cancer, there can be a small amount of cancer cells still left in the body. Because of this, doctors use the word “remission” is used more often. This means there are no signs or symptoms of cancer. Patients in remission are followed closely for any signs of cancer returning. Sometimes, more chemotherapy may be given while in remission to prevent the cancer from coming back.

Doctors usually do not consider a patient “cured” until the chance of cancer returning is extremely low. If cancer does return, it usually happens within 5 years of having a remission. Because of this, doctors do not consider a patient cured unless the cancer has not come back within 5 years of remission. The five-year cutoff does not apply to all cancers.

Carboplatin + Abraxane® starting doses

  • Carboplatin AUC = 6, I.V. infusion given over 30 minutes on Day 1
  • Abraxane® 100 mg/m2 I.V. infusion given over 30 minutes on Days 1, 8, and 15

What is a CBC?

A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.

Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.

2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.

3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.

What is a CMP?

A Comprehensive Metabolic Panel (CMP) is a frequently ordered blood test that tells clinicians the status of your: 1) Electrolytes & Acid/Base status2) Kidney function, 3) Liver function, 4) Blood sugar, and 5) Calcium at the time the test was taken. It is commonly used to monitor liver and kidney function when beginning new medications such as chemotherapy. A total of 14 tests are run simultaneously and are shown below.

Electrolytes & Acid/Base status:
1) Sodium, 2) Potassium, 3) Carbon dioxide, 4) Chloride

Kidney Function:
5) BUN (blood urea nitrogen), 6) Serum creatinine (Scr)

Liver Function:
7) AST, 8) ALT, 9) Total bilirubin, 10) Alk Phos, 11) Albumin, 12) Total protein

Blood sugar:
13) Serum glucose

Calcium:
14) Serum calcium