Clinical Features of Oxaliplatin Induced Hypersensitivity Reactions and Therapeutic Approaches

Abstract

Oxaliplatin, a third generation novel platinum compound is the most effective first line chemotherapeutic agent for colorectal cancer (CRC) in combination with 5FU and leucovorin. It is indicated for pancreatic, gastric and testicular cancers combined with bevacuzimab, capecitabine, irinotecan and other cytotoxic agents. However, moderate to severe hypersensitivity reactions (HSR) during or after oxaliplatin infusion usually require cessation of chemotherapy or substitution of the key therapeutic drug which largely interferes with improved patient prognosis. This mini-review showcases recent and accepted opinions/approaches in oxaliplatin induced HSR management. Physicians and oncologists have varying attitudes regarding the decision to rechallenge the patient after an HSR experience, efficacy of desensitization protocols, effectiveness and selection of drugs for premedication and possibilities of cross sensitivity to other platinum agents (e.g. carboplatin). A brief insight into underlying molecular mechanisms and clinical manifestations of oxaliplatin induced HSR is offered. We have also discussed the management of oxaliplatin induced HSR and risk stratification for a successful and complete chemotherapeutic plan.

Overexpressed GATA3 enhances the sensitivity of colorectal cancer cells to oxaliplatin through regulating MiR-29b

“…Oxa is a novel platinum anticancer drug [ 5 ]. Its platinum atom combines with 1,2-diaminocyclohexane and an oxalic acid group to form a single enantiomeric structure that induces the apoptotic pathway, therefore achieves its tumor cell-killing effect.…”

“…Its platinum atom combines with 1,2-diaminocyclohexane and an oxalic acid group to form a single enantiomeric structure that induces the apoptotic pathway, therefore achieves its tumor cell-killing effect. Oxa is often used for the treatment of metastatic CRC, or in the adjuvant treatment for stage III Dukes C colon cancer after complete resection of the primary tumor [ 5 , 6 ]. Due to individual differences, many tumor patients still experience cancer recurrence and metastasis after multiple effective chemotherapies, due to tolerance of cancer cells to chemotherapy drugs [ 7 ].…”

Silencing GnT‑V reduces oxaliplatin chemosensitivity in human colorectal cancer cells through N‑glycan alteration of organic cation transporter member 2

“…According to cancer statistics for China, the incidence and mortality rates of CRC are third and fifth, respectively, among all types of cancer, which indicates that CRC is a major cause of cancer-associated deaths in China (2). At present, surgical resection followed by oxaliplatin-based chemotherapy is among the most frequently used therapeutic strategies (3,4). However, the long-term administration of oxaliplatin is associated with drug resistance, which has been a major barrier to the efficacy of CRC treatment (5,6).…”

Chemotherapy Acute Infusion Reactions: A Qualitative Report of the Perspectives of Patients With Cancer

“…These reactions occur during the actual infusion of chemotherapy and manifest as flushing, rash, fever, rigors, swelling of the face and throat, back pain, shortness of breath, chest pressure, hypotension, and, at times, cardiac dysfunction. [1][2][3][4] In the absence of stopping the chemotherapy and promptly initiating resuscitative measures, these reactions can be fatal. [1][2][3][4] Although patients are often premedicated to prevent or lessen the risk of a reaction, these reactions still occur, leaving patients with limited treatment options or with logistical challenges during the administration of future cancer treatment.…”

“…[1][2][3][4] In the absence of stopping the chemotherapy and promptly initiating resuscitative measures, these reactions can be fatal. [1][2][3][4] Although patients are often premedicated to prevent or lessen the risk of a reaction, these reactions still occur, leaving patients with limited treatment options or with logistical challenges during the administration of future cancer treatment. 5,6 The estimated incidence of an acute infusion reaction with carboplatin or oxaliplatin is in the range of 12% to 19%.…”