Paclitaxel-Associated  Hypersensitivity Reactions:  Experience of the Gynecologic Oncology Program of the Cleveland Clinic Cancer  Center

Markman, Maurie; Kennedy, Alexander W.; Webster, Kenneth; Kulp, Barbara; Peterson, Gertrude; Belinson, Jerome L.

doi:10.1200/jco.2000.18.1.102

Cited by 165 publications

(119 citation statements)

References 10 publications

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“…Because paclitaxel is dissolved in the highly allergenic cremaphor, hypersensitivity reactions may occur. 9 Symptoms of tachypnea, tachycardia, and hypotension may occur within minutes of instituting paclitaxel. Premedicating patients with steroids, H1 and H2 blockers, and prolonging the infusion time may prevent the development of this anaphylactoid reaction.…”

Section: Discussionmentioning

confidence: 99%

Severe interstitial pneumonitis associated with docetaxel administration

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Mortimer

Picus

2002

Cancer

109

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BACKGROUNDInterstitial pneumonitis has not been reported as a toxicity of docetaxel. The authors report the presentation and natural history of four patients who developed a severe interstitial pneumonitis after receiving docetaxel.METHODSThe hospital and outpatient records of patients treated with docetaxel were reviewed to identify whether any of these patients required an evaluation for respiratory problems.RESULTSFour patients developed an interstitial pneumonitis that could be explained only as a toxicity of docetaxel. None had metastatic disease to the lung, and all had normal liver function before receiving chemotherapy. The patients presented with acute dyspnea and fever within 1–2 weeks of receiving docetaxel. All developed progressive interstitial infiltrates and respiratory failure that required mechanical ventilation. An exhaustive workup for other causes of pneumonitis was negative. Broad‐spectrum antibiotics and corticosteroids were ineffective. Two patients died of complications related to the pulmonary process. The two survivors required ventilatory support for more than 21 days. The clinical and pathologic findings of these patients are presented.CONCLUSIONSInterstitial pneumonitis is a rare and potentially fatal complication of docetaxel treatment. Prolonged ventilatory support is appropriate in patients with a favorable prognosis. Cancer 2002;94:847–53. © 2002 American Cancer Society.DOI 10.1002/cncr.10263

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Section: Discussionmentioning

confidence: 99%

Severe interstitial pneumonitis associated with docetaxel administration

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Mortimer

Picus

2002

Cancer

109

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“…19 . In 95% of cases, reactions occur during the first or second infusion 20 , but reactions can appear during subsequent infusions (3%) 19,20 . Some patients also develop skin reactions several days or up to a week after infusion.…”

Section: 12mentioning

confidence: 99%

Management of Hypersensitivity to Platinum- and Taxane-Based Chemotherapy: cepo Review and Clinical Recommendations

et al. 2014

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“…Most patients who experience a mild-to-moderate reaction (grade 1 or 2) during the first exposure, such as those often seen with taxanes and monoclonal antibodies, will tolerate readministration of the agent using a slower infusion rate and premedication after all symptoms have resolved [1,6,11,14,20,27,39]. Rechallenge is generally discouraged in patients who have a severe initial reaction (grade 3 or 4), underscoring the need for accurate grading of hypersensitivity reactions and infusion reactions (Table 1).…”

Section: Managementmentioning

confidence: 99%

“…For monoclonal antibodies, reducing the infusion rate by half (e.g., from 100 mg/hour to 50 mg/hour for rituximab or from a maximum rate of 5 ml/ minute to 2.5 ml/minute for cetuximab) is recommended [20,27]. Desensitization protocols have been used with some success in patients who experience severe hypersensitivity reactions to taxanes [9,11,39].…”

Section: Managementmentioning

confidence: 99%

Management and Preparedness for Infusion and Hypersensitivity Reactions

2007

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LEARNING OBJECTIVESAfter completing this course, the reader will be able to:1. Discuss the physiology of the different clinical hypersensitivity and infusion reactions to monoclonal antibodies and chemotherapy.2. Select appropriate prevention and treatment strategies for hypersensitivity reactions.3. Describe the differences between acquired and acute hypersensitivity reactions.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTBackground. Like nearly all systemic cancer therapies, monoclonal antibodies are associated with hypersensitivity reactions. This article reviews the characteristics and management of hypersensitivity reactions to monoclonal antibodies and commonly used chemotherapy agents. Methods. MEDLINE was searched for recent studies and reviews pertaining to hypersensitivity reactions with monoclonal antibodies (cetuximab, rituximab, trastuzumab, panitumumab, bevacizumab), platinum compounds (carboplatin, oxaliplatin), and taxanes (paclitaxel, docetaxel). Emphasis was placed on articles that provided practical information on hypersensitivity reaction management. Data found in the literature were supplemented with information from the package insert for each agent.Results. Severe hypersensitivity reactions are rare, with an incidence of <5%, provided patients receive proper premedication, close monitoring, and prompt intervention when symptoms occur. Hypersensitivity reactions to platinum compounds are generally consistent with type 1 hypersensitivity, occurring after multiple cycles of therapy. Reactions to taxanes and mono-

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Paclitaxel-Associated Hypersensitivity Reactions: Experience of the Gynecologic Oncology Program of the Cleveland Clinic Cancer Center

Abstract: On the basis of this large single-institution study of paclitaxel-associated hypersensitivity reactions, we conclude that with appropriate precautions essentially all individuals experiencing these reactions can be safely treated with this agent.

Cited by 165 publications

References 10 publications

Severe interstitial pneumonitis associated with docetaxel administration

Severe interstitial pneumonitis associated with docetaxel administration

Management of Hypersensitivity to Platinum- and Taxane-Based Chemotherapy: cepo Review and Clinical Recommendations

Management and Preparedness for Infusion and Hypersensitivity Reactions

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