Examination on the Effect of Docetaxel Dilution Concentration on the Hypersensitivity Revelation Rate

Abstract

Docetaxel is an extensively used taxane, frequently associated with hypersensitivity reactions (HSR). We examined whether the dilution concentration affects the incidence rate of HSR, and set up a concentration that can control HSR. We also established management of HSR that were caused by docetaxel. Retrospective analysis was performed at a single institution in 471 consecutive patients treated with the regimen, including docetaxel for breast cancer, gastric cancer, non-small-cell lung cancer, prostate cancer and skin cancer from 2006 to 2011. Among 471 patients, 90 were in the 250 mL group and 381 were in the 500 mL group. The rate of HSR was 14.4％ in the 250 mL group vs 2.4％ in the 500 mL group (P＜0.01). Regarding the duration of HSR, there was no significant difference between the two groups (1.69 ± 0.75 cycles vs 2.22 ±1.71 cycles). The seriousness of HSR was similar in the two groups (250 mL groups; G1:61.5％, G2:30.8％, G3/G4:7.7％ vs 500 mL groups; G1:77.8％, G2:11.1％, G3/G4:11.1％). Moreover, no difference was found in the rate of HRS below 0.02 w/v％ standard concentration, when all patients were divided into another two groups (above the standard concentration; Above Group, below the standard concentration; Below Group). In conclusion, our present data suggest that the dilution concentration of docetaxel strongly affects the rate of HSR. Moreover, if the dilution concentration of docetaxel is below 0.02 w/v％ (cutoff value), it is suggest that HSR can be controlled. These findings show that the dilution concentration of docetaxel can become a tool that for controlling HRS in addition to the existing premedication.