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Treatment Name: Carboplatin + Docetaxel (Taxotere®)

Carboplatin + Docetaxel (Taxotere®) is a Chemotherapy Regimen for Ovarian Cancer

How does carboplatin + docetaxel (Taxotere®) work?
Each of the medications in carboplatin + docetaxel are designed to kill or slow the growth of ovarian cancer cells.

Goals of therapy:
Carboplatin + docetaxel is given to shrink ovary tumors and alleviate symptoms caused by ovarian cancer. If the disease is not metastatic, treatment is commonly given with the goal of cure. If the disease is metastatic, treatment is not commonly given with the goal of cure.

Schedule

Every 21-Day Regimen Schedule

  • Carboplatin intravenous (I.V.) infusion over 30 minutes on Day 1
  • Docetaxel I.V. infusion over 60 minutes on Day 1
  • Dexamethasone 8 mg (two 4 mg tablets) by mouth twice daily the day before, the day of, and the day after docetaxel

Every 28-Day Regimen Schedule (lower weekly doses)

  • Carboplatin I.V. infusion over 30 minutes on Days 1, 8, and 15
  • Docetaxel I.V. infusion over 60 minutes on Days 1, 8, and 15
  • Dexamethasone 4 mg by mouth the night before, the morning of, and night of docetaxel infusion

Estimated total infusion time for this treatment:

  • Up to two hours for Day 1 of each Schedule type (21-day or 28-day). Up to two hours for Days 8 and 15 (if applicable)
  • 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 + docetaxel is usually given in an outpatient infusion center, allowing the person to go home afterwards. On occasion, it may be given in the hospital if someone is too sick.

Carboplatin + docetaxel is repeated every 21 or 28 days. This is known as one Cycle. If the disease is not metastatic, each cycle may be repeated up to 6 times, depending upon the stage of the disease. If the disease is metastatic, each cycle of carbo/docetaxel may be repeated until the regimen no longer works or until unacceptable side effects occur. Duration of therapy depends upon response, tolerability, and number of cycles prescribed.

Click here for the common carboplatin + docetaxel (Taxotere) starting doses.

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 carboplatin + docetaxel side effects are shown here. Side effects sometimes have percentage ranges [example 64 – 88%] because they differed between clinical studies:

On average, between 8 - 31% of patients discontinue treatment due to unacceptable side effects. The most common side effect causing early discontinuation of therapy is an intolerable infusion reaction to carboplatin.

Note: Because clinical studies with carboplatin + docetaxel were conducted prior to the availability of many newer anti-nausea medications that we have today, the percentage of patients who reported nausea and vomiting in this study may be higher than seen now.

*Hair loss from carboplatin + docetaxel is often noticeable. A wig or hair piece may be desired to camouflage the absence of hair until it grows back.

**An infusion reaction may consist of the following: redness, fast heart beat, low blood pressure, shortness of breath or wheezing, anxiety or feeling warm. If the symptoms go away after stopping the infusion and the receipt of medications such as antihistamines and corticosteroids, your doctor may recommend restarting the infusion at a slower rate. Docetaxel infusion reactions may occur with any dose. Carboplatin infusion reactions, on average, occurred with the 8th dose or later.

Side effect videos Side Effect Videos
Hair LossHair LossAnemiaAnemiaDiarrheaDiarrheaNausea and VomitingNausea and VomitingBleedingBleedingNeutropenic FeverNeutropenic FeverPainPainFatigue Fatigue

Monitoring

How often is monitoring needed?
Labs (blood tests) may be checked before each treatment or at your doctor’s discretion. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), CA-125 (a tumor marker for ovarian cancer), plus any others your doctor may order.

How often is imaging needed?
Imaging may be checked before treatment and periodically during treatment. Imaging may include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.

How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue carboplatin + docetaxel as planned, delay treatment for low blood counts or side effects, decrease doses for low blood counts, or switch to an alternative therapy.

ChemoExperts Tips

  • Carboplatin hypersensitivity reaction can be severe. This reaction is most common around the 8th or 9th cycle, 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 report them immediately, even after they have left the clinic
  • Remember to take dexamethasone to help prevent excess fluid from staying in your body as a result of docetaxel treatment. If you forget, be sure to alert the doctor, pharmacist, or nurse at the infusion center. An intravenous dose of dexamethasone may be given if you forget any doses at home
  • A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
  • Clinical trials may exist for ovarian 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 + Docetaxel (Taxotere®), 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 + Docetaxel (Taxotere®). Depending upon your income, they may be able to help cover the cost of:

  • Carboplatin
  • Taxotere®

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 + Docetaxel (Taxotere®) 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 + Docetaxel (Taxotere®)

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.

Taxotere® (Docetaxel)

  • Taxotere ​is an intravenous (I.V.) infusion
  • There is an increased  chance of death in patients treated with this drug who have poor liver function, are treated with higher doses, in patients with non-small cell lung cancer and a history of using other “platinum-based chemotherapy” drugs
  • Docetaxel should not be given when a certain blood cell count, neutrophils, get below 1500 cells.  The physician may hold therapy or reduce the dose and continue treatment if this occurs
  • Dosage adjustment may be required for poor liver function
  • Severe fluid retention may occur, especially when combined with prednisone
  • Docetaxel may interact with strong CYP3A4 inhibitors (e.g. ketoconazole) and proteosome inhibitors (e.g. Ritonavir) may increase concentrations of docetaxel and lead to increased toxicity or side effects. More frequent laboratory monitoring and docetaxel dosage adjustment may be needed
  • Severe hypersensitivity may occur, although rare
General Taxotere (Docetaxel) Side Effects
  • Hair loss
  • Low red blood cell count and fatigue
  • Nausea/vomiting
  • Diarrhea
  • Low white blood cell count and associated infections. Blood cell counts, including neutrophils (ANC) should be checked regularly
  • Nail changes on fingers and toes
  • Loss of sensation
  • Swelling in the extremities
  • Mouth sores 
  • Changes in taste
  • Loss of appetite
  • Shortness of breath
  • Muscle pain
  • Tearing of eyes or vision problems
  • Heart problems
  • Click on the taxotere (Docetaxel) package insert below for reported side effects and possible drug interactions

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

See DailyMed package insert.

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References

1) Markman M, Kennedy A, Webster K, et al. Combination chemotherapy with carboplatin and docetaxel in the treatment of cancers of the ovary and fallopian tube and primary carcinoma of the peritoneum. J Clin Oncol. 2001;19:1901-1905.

2) Strauss HG, Henze A, Teichmann A, et al. Phase II trial of docetaxel and carboplatin in recurrent platinum-sensitive ovarian, peritoneal and tubal cancer. Gynecol Oncol. 2007;104(3):612-616.

3) Kushner DM, Connor JP, Sanchez F, et al. Weekly docetaxel and carboplatin for recurrent ovarian and peritoneal cancer: a phase II trial. Gynecol Oncol. 2007;105:358-364.

Created: February 19, 2017 Updated: October 8, 2018

What is Ovarian Cancer?

What is Ovarian Cancer?
A disease of the cells found in the ovaries in women. Ovarian cancer is not common, but is the fifth leading cause of cancer related death in women. The exact cause is not known, however risk factors include: older age, obesity, first period at an early age, late menopause, hormone replacement therapy (HRT) after menopause, family history, and genetic causes such as the BRCA (pronounced "bracka") mutation. The use of oral contraceptives or having one or more full-term pregnancies can decrease the risk of ovarian cancer.

The stage of ovarian cancer can vary at diagnosis and throughout treatment. Ovarian cancer is staged using the Tumor, Node, Metastasis (TNM) staging system, as well as Stage Grouping I, II, III, or IV. Staging systems describe the extent of cancer throughout the body and help doctors determine which treatments to offer. 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.

Common carboplatin + docetaxel (Taxotere) starting doses

Every 21-Day Regimen Schedule

  • Carboplatin AUC 5 - 6 intravenous (I.V.) infusion over 30 minutes on Day 1
  • Docetaxel 60 - 75 mg/m2 I.V. infusion over 60 minutes on Day 1
  • Dexamethasone 8 mg (two 4 mg tablets) by mouth twice daily the day before, 8mg twice the day of, and 8mg twice the day after docetaxel

Every 28-Day Regimen Schedule (lower weekly doses)

  • Carboplatin "AUC 2" I.V. infusion over 30 minutes on Days 1, 8, and 15
  • Docetaxel 35 mg/m2 (Max BSA = 2) I.V. infusion over 60 minutes on Days 1, 8, and 15
  • Dexamethasone 4 mg by mouth the night before, 4 mg the morning of docetaxel, then 4 mg later that evening

Note: Individual doses may vary based upon your Doctor's recommendation, or drug availability

Clinical Studies

If you are interested in reading the clinical trials results, please click on references below:

1) Markman M, Kennedy A, Webster K, et al. Combination chemotherapy with carboplatin and docetaxel in the treatment of cancers of the ovary and fallopian tube and primary carcinoma of the peritoneum. J Clin Oncol. 2001;19:1901-1905.

2) Strauss HG, Henze A, Teichmann A, et al. Phase II trial of docetaxel and carboplatin in recurrent platinum-sensitive ovarian, peritoneal and tubal cancer. Gynecol Oncol. 2007;104(3):612-616.

3) Kushner DM, Connor JP, Sanchez F, et al. Weekly docetaxel and carboplatin for recurrent ovarian and peritoneal cancer: a phase II trial. Gynecol Oncol. 2007;105:358-364.

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

What is dexamethasone?

Dexamethasone is an anti-inflammation drug that helps calm your body's reactions to many chemotherapy treatments

What does metastatic mean?

Metastatic disease is when cancer cells have spread from their primary (original) location to other parts of the body and started more tumor(s).