Why is AUC preferred over BSA for carboplatin dosing?

The preference for using the area under the concentration-time curve (AUC) for dosing carboplatin stems from its ability to provide a more individualized and accurate dosing strategy compared to body surface area (BSA). AUC correlates better with the pharmacodynamics and efficacy of the drug, reflecting the total exposure of the patient to the drug over time. This method accounts for variations in drug absorption, distribution, metabolism, and elimination specific to each patient, which can significantly impact therapeutic outcomes and toxicity profiles.

Using AUC allows for adjustments based on renal function and patient-specific factors, ultimately facilitating more effective management of dosing to achieve optimal therapeutic levels while minimizing adverse effects. This individualized approach is especially relevant for drugs like carboplatin, where renal clearance plays a critical role in drug elimination.

In contrast, while BSA is a widely used dosing method in chemotherapy, it does not account for individual pharmacokinetic differences as effectively, which can lead to suboptimal dosing. Therefore, relying on AUC enhances the precision of carboplatin therapy and aligns better with its pharmacodynamics, leading to improved patient care.