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NCCN Chemotherapy Order Templates Appendix B Appendix B: Carboplatin Dosing Cockcroft-Gault Equation1 Substitute GFR with creatinine clearance that is calculated via Cockcroft-Gault equation CrCl Calculation (Cockroft-Gault Formula): CrCl (men; mL/min) = (140 – age) x (weight in kg) ÷ (serum creatinine [mg/dL] x 72) CrCl (women; mL/min) = 0.85 x CrCl (men) Isotope Dilution Mass Spectrometry (IDMS) Utilizes standardized method to measure serum creatinine (SCr) utilized by US clinical laboratories2 May underestimate SCr values compared to older methods when the SCr values are relatively low Calvert Equation3 Calvert equation: Dose (mg) = Target AUC x (glomerular filtration rate [GFR]* + 25) *GFR estimated by calculated creatinine clearance. Maximum Carboplatin Dose Calculation2 The FDA has recommended a maximum creatinine clearance (CrCl) for use in calculating carboplatin doses to minimize toxicity. The maximum dose is based on a GFR estimate that is capped at 125 ml/min for patients with normal renal function. If the carboplatin dose is calculated utilizing the IDMS-derived CrCl (GFR) within the Calvert equation, carboplatin dosing could be higher than desired, and could result in increased drug-related toxicities. Maximum Carboplatin Dose (mg) = Target AUC (mg∙min/mL) x (150 mL/min) © 2011 National Comprehensive Cancer Network 1 REFERENCE 1. Cockcroft DW, Gault MH. Nephron. 1976;16(1):31-41. 2. FDA Center for Drug Evaluation and Research. Carboplatin dosing. http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm228974.htm. October 8, 2010. Accessed April 15, 2011. 3. Calvert AH, Newell DR, Gumbrell LA, et al. J Clin Oncol. 1989;7(11):1748-56 © 2011 National Comprehensive Cancer Network 2