Impact of carboplatin hypersensitivity and desensitization on patients with recurrent ovarian cancer

Altwerger, Gary; Florsheim, Esther; Menderes, Gulden; Black, Jonathan; Schwab, Carlton L.; Gressel, Gregory M.; Nelson, Warren O.; Carusillo, Nina; Passante, Terri; Huang, Gloria S.; Litkouhi, Babak; Azodi, Masoud; Silasi, Dan Arin; Santin, Alessandro D.; Schwartz, Peter E.; Ratner, Elena

doi:10.1007/s00432-018-2753-y

Cited by 22 publications

(31 citation statements)

References 31 publications

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“…Desensitization is a safe and highly effective procedure, not only for IgE-mediated reactions but also for those mediated by non-IgE mechanisms [3,5]. The benefits of the procedure include an improvement in the overall survival of treated patients compared to using no-first line treatments [5][6][7], as well as a reduction in costs [5]. The likelihood of breakthrough reactions (BTR) during desensitization is low and, moderate to severe reactions are infrequent [8].…”

Section: Introductionmentioning

confidence: 99%

Hypersensitivity Reactions to Cancer Chemotherapy: Practical Recommendations of ARADyAL for Diagnosis and Desensitization

Vega¹,

Jiménez-Rodriguez²,

Barranco³

et al. 2021

J Investig Allergol Clin Immunol

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Section: Introductionmentioning

confidence: 99%

Hypersensitivity Reactions to Cancer Chemotherapy: Practical Recommendations of ARADyAL for Diagnosis and Desensitization

Vega¹,

Jiménez-Rodriguez²,

Barranco³

et al. 2021

J Investig Allergol Clin Immunol

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“…It has proved to be a safe procedure when performed by experienced allergists. It has no additional costs and survival outcomes with no differences from those via standard administration ( 3 , 4 , 43 , 44 ).…”

Section: Discussionmentioning

confidence: 99%

Use of Rapid Drug Desensitization in Delayed Hypersensitivity Reactions to Chemotherapy and Monoclonal Antibodies

2022

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Background:Rapid drug desensitization (RDD) allows first-line therapies in patients with immediate drug hypersensitivity reactions (DHR) to chemotherapeutic drugs (ChD) and monoclonal antibodies (mAb). Desensitization in delayed drug reactions has traditionally used slow protocols extending up to several weeks; RDD protocols have been scarcely reported.Patients and Method:We retrospectively analyzed the patients referred to the Allergy Department, who had experienced a delayed DHR (> 6 h) related to a ChD or mAb and underwent an RDD protocol. The rate of successful administration of the offending drug and the presence of adverse reactions were evaluated.Results:A total of 93 RDDs were performed in 11 patients (including 6 men and 5 women, with a median age of 61 years). The primary DHR were maculopapular exanthema (MPE) (8), generalized delayed urticaria (1), MPE with pustulosis and facial edema (1), and facial edema with desquamative eczema (1). The meantime for the onset of symptoms was 3 days (range 1–16 days). RDD was performed using a protocol involving 8–13 steps, with temozolomide (25), bendamustine (4), rituximab (9), infliximab (24), gemcitabine (23), and docetaxel (8), within 4.6–6.5 h. Sixteen breakthrough reactions were reported during the RDD (17.2 %) in 5 patients; all were mild reactions including 11 delayed and 5 immediate reactions. All patients completed their treatment.Conclusions:RDD is a potentially safe and effective procedure in patients suffering from delayed reactions to ChD and mAb. It allows them to receive full treatment in a short period, thereby reducing time and hospital visits.

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“…24 Another study showed that patients who were desensitized to carboplatin hypersensitivity had longer OS than patients without hypersensitivity to carboplatin not undergoing desensitization. 25 TTP was analyzed for the first time in this study. Although there was no statistical difference, the RDD group showed a longer TTP, despite the time to relapse and the number of previous chemotherapy cycles being higher.…”

Section: Discussionmentioning

confidence: 99%

Does Carboplatin Rapid Desensitization Change Its Adverse Drug Reactions Other than Hypersensitivity and Efficacy in Patients With Ovarian Cancer?

Park

Lee

Kim

et al. 2020

Allergy Asthma Immunol Res

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Purpose Rapid drug desensitization is known to be a good strategy in patients with drug hypersensitivity to chemotherapy. However, changes in maximal drug concentration and exposure time in blood through desensitization may alter other adverse reactions and efficacy of the drug. We investigated rapid desensitization for carboplatin in terms of severe adverse drug reactions (ADRs) and efficacy compared with the standard infusion. Methods A retrospective cohort study was conducted on patients with recurrent ovarian cancer who received carboplatin chemotherapy from 2017 to 2019. We compared serious adverse events (SAEs), ADRs according to organ classes, time to progression (TTP), and overall survival (OS). Results Of 108 desensitization procedures performed in 21 patients, 104 were successfully accomplished (96.3%). There were compared with 271 procedures in 41 patients who received the standard infusion method. There were 8 (7.7%) SAEs in the rapid desensitization group and 34 (12.5%) in the control group. One drug-related death occurred in the rapid desensitization group. In the rapid desensitized group, except for neutropenia, there was no statistically significant increase in SAEs and over grade 3 of ADRs according to organ classes compared with the control group. In the efficacy analysis, TTP and OS were similar in the 2 groups. Conclusions Rapid desensitization of carboplatin can lower the risk of immediate hypersensitivity reactions without changing the inherent effect and severe ADRs.

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Impact of carboplatin hypersensitivity and desensitization on patients with recurrent ovarian cancer

Cited by 22 publications

References 31 publications

Hypersensitivity Reactions to Cancer Chemotherapy: Practical Recommendations of ARADyAL for Diagnosis and Desensitization

Hypersensitivity Reactions to Cancer Chemotherapy: Practical Recommendations of ARADyAL for Diagnosis and Desensitization

Use of Rapid Drug Desensitization in Delayed Hypersensitivity Reactions to Chemotherapy and Monoclonal Antibodies

Does Carboplatin Rapid Desensitization Change Its Adverse Drug Reactions Other than Hypersensitivity and Efficacy in Patients With Ovarian Cancer?

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