Adjunct Histamine Blockers as Premedications to Prevent Carboplatin Hypersensitivity Reactions

Abstract

Total lifetime exposure to carboplatin remains the greatest predictive factor of CHR in women with ovarian cancer. Although data analysis indicates the addition of premedications for all ovarian cancer patients receiving carboplatin did not result in a statistically significant reduction in CHRs, a patient benefit in CHR reduction was observed. A prospective study is needed to confirm these findings.

Effect of Prophylactic Extended-Infusion Carboplatin on Incidence of Hypersensitivity Reactions in Patients with Ovarian, Fallopian Tube, or Peritoneal Carcinomas

“…Two groups of investigators evaluated the association of a triple premedication regimen that included a corticosteroid, H 1 antagonist, and H 2 antagonist with the incidence of carboplatin HSRs in retrospective chart reviews. 4,17 Both groups found a nonsignificant reduction in carboplatin HSRs in patients with ovarian cancer but observed ã 50% decrease in the incidence of HSRs with the triple premedication regimen, which may be clinically significant. To our knowledge, our study is the first evaluation to find that a tripletherapy premedication regimen is significantly associated with reducing the incidence of carboplatin HSRs.…”

“…All of these strategies were successful at preventing repeat HSRs in most patients, but due to the differences in the desensitization protocols, the influence of the premedication regimen versus infusion time cannot be determined. Two groups of investigators evaluated the association of a triple premedication regimen that included a corticosteroid, H 1 antagonist, and H 2 antagonist with the incidence of carboplatin HSRs in retrospective chart reviews . Both groups found a nonsignificant reduction in carboplatin HSRs in patients with ovarian cancer but observed a ~50% decrease in the incidence of HSRs with the triple premedication regimen, which may be clinically significant.…”

Anaphylaxis—a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis

“…199 Topic area 2 included studies. The following studies were used in the analyses of questions 2 to 5: Question 2: Alqurashi et al, 42 Brady et al, 173 Brown et al, 21 Calvani et al, 175 Douglas et al, 178 Ellis and Day, 39 Grunau et al, 200 Guiot et al, 201 Inoue and Yamamoto, 179 Jirapongsanunuruk et al, 180 Kawano et al, 202 Ko et al, 181 Lee et al, 203 Lee and Greenes, 142 Lee et al, 182 Lertnawapan and Maek-a-nantawat, 183 Lin et al, 204 Manuyakorn et al, 185 Mehr et al, 186 Michelson et al, 166 Oya et al, 205 Poachanukoon and Paopairochanakorn, 189 Rohacek et al, 41 Scranton et al, 190 Smit et al, 191 Sricharoen et al, 55 Stark and Sullivan, 37 Vezir et al 192 Question 3: Chang et al, 206 Francis et al, 207 Jerzak et al, 208 Mach et al, 209 Onetto et al, 210 Rougier, 211 Seki et al, 212 Shen et al, 213 Thompson et al, 214 Trudeau et al, 215 Weiss et al 198 Question 4: Abe et al, 216 Katayama et al, 217 Kolbe et al,…”

G Protein-Coupled Receptors (GPCRs)-Mediated Calcium Signaling in Ovarian Cancer: Focus on GPCRs activated by Neurotransmitters and Inflammation-Associated Molecules

“…The reduction of hypersensitivity reactions to chemotherapeutic drugs (i.e., paclitaxel) in patients with ovarian cancer was also obtained by premedication with pemirolast, an antiallergic agent, that is rather diminishing the release of sensory peptides than inhibiting the histamine release [111]. In a retrospective study, women with ovarian cancer that received premedication with antagonists of H1 and H2, in addition to dexamethasone, had approximately half the risk of carboplatin hypersensitivity reactions compared with patients without premedication and the overall incidence of carboplatin hypersensitivity reactions decreased after addition of premedication [112], Figure 7. In another retrospective study, 14 out of 105 women with ovarian cancer had severe hypersensitivity reactions to paclitaxel administration, regardless premedication with glucocorticoid or H1/H2 antagonists, and chemotherapy was ceased or discontinued [113].…”

“…On the other hand, some authors consider histamine receptors as potential pharmacological targets in ovarian cancer. Despite some positive results in the reduction of hypersensitivity reactions to chemotherapeutic agents in ovarian cancer patients [112], antihistamines should be used with caution in these patients as results might be biased by the fact that hypersensitivity reactions to chemotherapeutic agents are commonly associated with tryptase and histamine release from mast cells in the serum [110].…”