Carboplatin and paclitaxel

Say it: KAR-bo-PLA-tin and PAK-li-TAX-el

Carboplatin and paclitaxel

Carboplatin and paclitaxel is a two medicine chemotherapy used for many cancers, including lung, ovarian, uterine, esophagus and head and neck cancer.

Also called: carbo taxol, carbo/taxol, carbo/pac, CP, PC, carboplatin Taxol, paclitaxel carboplatin, weekly carbo taxol, carbo taxol with radiation, CROSS regimen, carboplatin paclitaxel pembrolizumab, carbo taxol Keytruda, KEYNOTE-407 regimen

What it is

Carboplatin and paclitaxel damage cancer cells in two different ways, so they work well together. This pair can be given alone, with radiation, or with an immunotherapy medicine that helps your immune system fight the cancer. When it is used with radiation or after surgery, the goal is often cure. When cancer has spread, the goal is to shrink it, slow it down and help you live longer and feel better.

Often used for

• Non-small cell lung cancer that has spread, often with an immunotherapy added
• Stage 3 lung cancer, given at the same time as radiation
• Ovarian, fallopian tube and primary peritoneal cancer
• Endometrial (uterine) cancer, often with an immunotherapy added
• Esophagus cancer before surgery, given with radiation
• Head and neck cancer, and cancer of unknown primary (where the starting place is not known)

Every 3 weeks

The most common version. Both medicines are given on day 1, and each cycle is 21 days. For lung cancer that has spread, most people get 4 to 6 cycles. For ovarian and endometrial cancer, most people get 6 cycles.

Weekly

Paclitaxel is given once a week (days 1, 8 and 15), and carboplatin is given either weekly or every 3 weeks. Smaller weekly doses may cause less hair loss and fewer low blood counts for some people, and it is often used for people who are older or more frail. It is also a common choice for ovarian cancer.

With radiation

Low weekly doses of both medicines are given once a week during radiation, which is given 5 days a week. For stage 3 lung cancer this lasts about 6 to 7 weeks. Afterward, many people get immunotherapy (durvalumab) for up to 1 year, or a targeted pill if the tumor has an EGFR gene change. For esophagus cancer, weekly treatment with radiation lasts about 5 weeks, followed by surgery.

With pembrolizumab for squamous lung cancer

Used first for squamous non-small cell lung cancer that has spread. Pembrolizumab is added on day 1 every 3 weeks for 4 cycles. Then the chemotherapy stops and pembrolizumab continues alone for up to about 2 years in total, as long as it is working. Nab-paclitaxel, a related medicine, is sometimes used in place of paclitaxel.

With immunotherapy for endometrial cancer

For advanced or returning uterine cancer, pembrolizumab or dostarlimab (or sometimes durvalumab) is added for 6 cycles. Then the immunotherapy continues alone for a set time. It helps most when tumor testing shows mismatch repair deficiency (dMMR), but it can help others too.

For ovarian cancer

Usually 6 cycles, given before and/or after surgery. Bevacizumab may be added. Afterward, some people take a maintenance pill (a PARP inhibitor) based on gene testing.

The medicines in this plan

Carboplatin

Platinum chemotherapy. Given through a vein over about 30 to 60 minutes. Your dose is based on how well your kidneys work.

Paclitaxel

Taxane chemotherapy that stops cancer cells from dividing. Given through a vein over about 3 hours every 3 weeks, or over about 1 hour in weekly plans. Medicines to prevent allergic reactions are given first.

Pembrolizumab

Only in the immunotherapy version. Takes the brakes off your immune system so it can attack cancer. Given through a vein over about 30 minutes on day 1.

Dostarlimab

Only in some endometrial cancer plans. An immunotherapy that works like pembrolizumab. Given through a vein over about 30 minutes on day 1.

Bevacizumab

Only in some ovarian cancer plans. An antibody that cuts off the blood supply tumors need to grow. Given through a vein on day 1.

How you get it

Carboplatin and paclitaxel are given in an outpatient infusion clinic, through an IV or a port (a small device placed under the skin of the chest). In the every 3 week plan, a treatment day takes about 4 to 6 hours, and cycles repeat every 21 days. In weekly plans, visits are shorter, often 2 to 3 hours. How many cycles you get depends on your cancer type and the goal of treatment. Your schedule may be different.

A typical cycle

Day 1

Blood tests and a check in with your team. Then premedicines (a steroid, an allergy medicine and a stomach medicine) and anti-nausea medicines. Then paclitaxel, then carboplatin. Any immunotherapy is given first.

Days 2 to 5

Muscle and joint aches, tiredness and mild nausea are most common now. Some people have trouble sleeping from the steroid.

Days 7 to 14

Blood counts are lowest. Watch closely for fever and signs of infection.

Days 15 to 21

Recovery before the next cycle. Scans are usually done every 2 to 3 cycles.

Common side effects and what helps

• Hair loss, usually starting 2 to 3 weeks after the first treatment. It grows back after paclitaxel stops.
• Tingling or numbness in fingers and toes from paclitaxel. It can build up over time, so tell your team at every visit.
• Muscle and joint aches for a few days after treatment. Ask which pain reliever is safe for you.
• Tiredness. Rest when you need to and try a short walk each day.
• Low blood counts, which raise the risk of infection, bleeding and tiredness. Wash hands often and stay away from people who are sick.
• Nausea, usually mild to moderate. Take your anti-nausea medicines as prescribed, even before you feel sick.
• Constipation or diarrhea. Drink plenty of fluids and ask about medicines that help.
• With radiation: sore throat and painful swallowing, tiredness and skin redness where the radiation is aimed. Soft foods and prescribed mouth rinses help.
• With immunotherapy: rash, itching, diarrhea or thyroid changes. Report them early so they can be treated.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Trouble breathing, chest tightness, flushing, rash, back pain or swelling of the face or throat during or soon after the infusion
• New or worse cough, shortness of breath or chest pain
• Diarrhea 4 or more times a day above your normal, or blood in your stool
• Not able to keep fluids down, or feeling dizzy when you stand
• Swallowing so painful that you cannot eat or drink (during radiation)
• Yellow skin or eyes, dark urine, or severe belly pain
• Bleeding that will not stop, or new bruises you cannot explain
• Numbness or weakness that makes it hard to walk, button clothes or hold things

Good to know

• You will have blood tests before each treatment to make sure your counts and kidneys are okay.
• Allergic reactions to paclitaxel are most likely during the first or second infusion, which is why premedicines are given and you are watched closely.
• After many cycles, some people become allergic to carboplatin, especially if they get it again later. Tell your team about any itching or flushing, even if it is mild.
• Paclitaxel contains a small amount of alcohol, and the allergy premedicine can make you sleepy. Do not drive yourself home after treatment.
• For lung and endometrial cancer, tumor testing (such as PD-L1, gene changes and mismatch repair) helps decide whether to add immunotherapy or use a different plan.
• Immunotherapy side effects can affect any organ, even months after the last dose. Blood tests check your thyroid, liver and kidneys.
• Chemotherapy can affect fertility. Do not get pregnant or father a child during treatment, and ask about fertility options before starting.

At home

• Keep a thermometer at home and check your temperature if you feel unwell.
• Have someone drive you home on treatment days.
• Check your feet every day if they feel numb, wear well fitting shoes, and keep floors clear to prevent falls.
• Drink about 8 to 10 cups of fluid a day unless your team told you otherwise.
• During radiation, eat soft, moist foods, avoid spicy or acidic foods, and use the mouth rinse your team gave you.
• If you get immunotherapy, carry a card or list saying so, and show it at any urgent care or ER.

Questions to ask

• What is the goal of my treatment, and how many cycles will I get?
• Will I get treatment weekly or every 3 weeks, and why?
• Will an immunotherapy be added, and what did my tumor testing show?
• Will I get radiation at the same time?
• What should I do if the tingling in my hands and feet gets worse?
• What treatment comes after this plan ends?

Lung cancer

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.