Characteristics of immediate hypersensitivity reaction to paclitaxel-based chemotherapy in gynecologic cancer patients

Thangwonglers, Thitinan; Santimaleeworagun, Wichai; Therasakvichya, Suwanit; Saengsukkasemsak, N.; Pimsi, Piyarat

doi:10.12932/ap-050520-0831

Cited by 3 publications

(4 citation statements)

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“…This response is manifested by flushing, itching, rash with back and chest pain [ 103 ]. If hypersensitivity reaction progresses to a moderate severity, symptoms of dyspnoea are added to the symptoms without a decrease in blood oxygen saturation and without a decrease in blood pressure [ 104 ]. In a severe stage of hypersensitivity reaction, the reaction is accompanied by hemodynamic instability, a decrease in blood oxygen saturation, nausea and vomiting.…”

Section: Pharmacology Of Taxanesmentioning

confidence: 99%

“…The most common taxane-induced skin symptoms typical of a hypersensitivity reaction are rash and pruritus, which are not serious. However, some patients may experience symptoms of hypersensitivity associated with systemic symptoms such as bronchospasm and blood pressure drop [ 104 ]. Skin toxicity is characterized by macular and papular skin changes that cause pruritus and pain.…”

Section: Pharmacology Of Taxanesmentioning

confidence: 99%

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Natural Taxanes: From Plant Composition to Human Pharmacology and Toxicity

Nižnanský

Osinová

Kuruc

et al. 2022

IJMS

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Biologically active taxanes, present in small- to medium-sized evergreen conifers of various Taxus species, are widely used for their antioxidant, antimicrobial and anti-inflammatory effects, but mostly for their antitumour effects used in the treatment of solid tumours of the breast, ovary, lung, bladder, prostate, oesophagus and melanoma. More of the substances found in Taxus plant extracts have medical potential. Therefore, at the beginning of this review, we describe the methods of isolation, identification and determination of taxanes in different plant parts. One of the most important taxanes is paclitaxel, for which we summarize the pharmacokinetic parameters of its different formulations. We also describe toxicological risks during clinical therapy such as hypersensitivity, neurotoxicity, gastrointestinal, cardiovascular, haematological, skin and renal toxicity and toxicity to the respiratory system. Since the effect of the drug-form PTX is enhanced by various Taxus spp. extracts, we summarize published clinical intoxications and all fatal poisonings for the Taxus baccata plant. This showed that, despite their significant use in anticancer treatment, attention should also be focused on the risk of fatal intoxication due to ingestion of extracts from these plants, which are commonly found in our surroundings.

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Section: Pharmacology Of Taxanesmentioning

confidence: 99%

Section: Pharmacology Of Taxanesmentioning

confidence: 99%

Natural Taxanes: From Plant Composition to Human Pharmacology and Toxicity

Nižnanský

Osinová

Kuruc

et al. 2022

IJMS

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“…6 Although the majority are mild to moderate, 7 anaphylaxis occurs in a small percentage of patients. 4,8,9 Reactions typically resolve with interruption of the drug, administration of fluids, and rescue medications if indicated. 10 Harmful sequelae have included patient anxiety; treatment interruptions, delays, or discontinuations; hospitalizations; and deaths.…”

Section: Introductionmentioning

confidence: 99%

“…9 Similar to reports in the literature, allergy expert consultation and drug desensitization appointments after a treatment-related HSR were increasing in our organization. 8,13 Without an institutional policy addressing the rate of taxane administration, taxanes were infused according to drug administration guidelines with no provision for rate titration. There are no widely accepted guidelines for taxane titration, and research supporting a standardized method to reduce HSRs is limited.…”

Section: Introductionmentioning

confidence: 99%

A Three-Step Taxane Titration Protocol Decreases Hypersensitivity Reactions During First and Second Exposures

Lynch

Menon

Mazzola

et al. 2023

JCO Oncology Practice

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INTRODUCTION Patients receiving taxanes are at risk for developing hypersensitivity reactions (HSRs) primarily during first and second lifetime exposures. Immediate HSRs require emergency care and can interfere with the continuation of preferred treatment. Although different approaches to slow titration have been used successfully for desensitization after HSR occurrence, there are no standardized recommendations for taxane titration to prevent HSRs. PURPOSE To determine if a gradual, three-step infusion rate titration decreases the rate and severity of immediate HSRs during first and second lifetime exposures to paclitaxel and docetaxel. METHODS We used a prospective, interventional design with historical comparisons to evaluate a sample of 222 first and second lifetime exposure paclitaxel and docetaxel infusions. The intervention was a three-step infusion rate titration provided at the initiation of first and second lifetime exposures. Ninety-nine titrated infusions were compared with 123 historical records of nontitrated infusions. RESULTS Compared with the nontitrated group (n = 123), the titrated group (n = 99) had significantly less HSRs (19% v 7%; P = .017). No significant difference in HSR severity was found between groups ( P = 1.00). However, four nontitrated patients received epinephrine, and one required transfer to the emergency department (ED) because of reaction severity. In contrast, no titrated patients received epinephrine or required transfer to the ED. In the nontitrated group, seven patients did not complete their infusions versus one patient in the titrated group. CONCLUSION A standardized, three-step infusion rate titration prevented HSR occurrence. Significant issues affecting practice feasibility and sustainability were addressed.

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Characteristics of immediate hypersensitivity reaction to paclitaxel-based chemotherapy in gynecologic cancer patients

Cited by 3 publications

References 0 publications

Natural Taxanes: From Plant Composition to Human Pharmacology and Toxicity

Natural Taxanes: From Plant Composition to Human Pharmacology and Toxicity

A Three-Step Taxane Titration Protocol Decreases Hypersensitivity Reactions During First and Second Exposures

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