Compare the principal toxicities of cisplatin and carboplatin.

• A. Cisplatin: nephrotoxicity, ototoxicity, severe N/V; Carboplatin: primarily myelosuppression with less nephro/ototoxicity.
• B. Cisplatin: primarily myelosuppression; Carboplatin: nephrotoxicity and ototoxicity.
• C. Both drugs have identical toxicity profiles.
• D. Carboplatin: severe nausea and vomiting; Cisplatin: minimal toxicities.

Answer: (A)

The main idea is that platinum-based drugs have different dominant toxicities. Cisplatin is notorious for non-hematologic toxicities that limit its use: kidney injury (nephrotoxicity), hearing loss (ototoxicity), and very strong nausea and vomiting. These effects are dose-limiting and require careful hydration, electrolyte management, and sometimes antiemetic strategies. Carboplatin, on the other hand, tends to cause bone marrow suppression (myelosuppression) as its primary toxicity, with kidney and ear toxicities being less pronounced. Emesis with carboplatin is generally less severe than with cisplatin, though it can still occur. So this option correctly assigns nephrotoxicity, ototoxicity, and severe vomiting to cisplatin, and predominant myelosuppression to carboplatin, with less impact on kidneys and ears.

The other choices don’t fit because they swap or minimize the well-established toxicity profiles, or claim identical toxicities for both drugs, which isn’t accurate.