carboplatin + mitoxantrone

Carboplatin and mitoxantrone is a chemotherapy combination used to treat various cancers, including acute leukemia (both myeloid and lymphoid) and transitional cell carcinoma of the bladder. Mitoxantrone is a synthetic anthracenedione that inhibits DNA repair by inhibiting topoisomerase II, resulting in DNA fragmentation. It also has immunosuppressive properties, inhibiting B cell, T cell, and macrophage proliferation, impairing antigen presentation, and reducing the secretion of interferon gamma, TNFα, and IL-2. Carboplatin is an alkylating agent developed as an analog of cisplatin, known for its reduced nephrotoxicity and emesis. It works by forming interstrand DNA cross-links, thereby interfering with DNA replication and transcription. This combination has been used in clinical contexts for acute leukemia (as part of the MECA regimen for refractory and relapsed acute myelogenous or lymphoid leukemia) and for transitional cell carcinoma of the bladder (including in veterinary medicine). When used in combination regimens, the initial dose of mitoxantrone should be reduced by 2-4 mg/m² below the recommended dose for single-agent usage. Mitoxantrone is always given as an intravenous injection in a clinical setting. Common side effects include hematological toxicity (particularly low white blood cell counts), cardiac toxicity (with risk factors like high cumulative dose, previous anthracycline therapy, prior mediastinal radiotherapy, pre-existing heart disease, and concomitant use of other cardiotoxic drugs), nausea and vomiting, and an increased risk of infections. The combination of carboplatin and mitoxantrone may increase the risk or severity of adverse effects compared to either drug alone.

Other names

MECA (when combined with etoposide and ara-C)