Paclitaxel hypersensitivity reactions: A role for docetaxel substitution

Lokich, J. J.; Anderson, Norwood

doi:10.1023/a:1008272114546

Cited by 26 publications

(7 citation statements)

References 6 publications

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“…Data on cross-reactivity of paclitaxel and docetaxel have been inconsistent. Previous small clinical trials (3-4 patients each) have described successful treatment with docetaxel following hypersensitivity reactions to paclitaxel [41,42]. However, a more recent retrospective review found that nine out of 10 patients treated with docetaxel following a hypersensitivity reaction to paclitaxel also reacted to docetaxel, suggesting a higher rate of crossreactivity [43].…”

Section: Rapid Drug Desensitization To Chemotherapeutic Agents: Taxanesmentioning

confidence: 98%

Desensitization regimens for drug allergy: state of the art in the 21st century

Liu

Fanning

Chong

et al. 2011

Clin Experimental Allergy

107

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Adverse reactions to drugs are increasingly being recognized as important contributions to disease in their own right as well as impediments to the best treatment of various conditions, including infectious, autoimmune, and neoplastic maladies. Rapid drug desensitization (RDD) is an effective mechanism for safely administering important medications while minimizing or entirely circumventing such adverse reactions in sensitized patients. We reviewed the literature on RDD in the last 10 years, including our experience from the Brigham and Women's Hospital Desensitization Program with hundreds of patients desensitized to a broad variety of drugs. RDD in our programme has been uniformly successful in patients with hypersensitivity reactions to antibiotics, chemotherapeutics, and monoclonal antibodies. Any reactions that occur during desensitization are generally much less severe than the initial hypersensitivity reaction to the drug, and patients have received the full dose of the desired medication 99.9% of the time out of (796) desensitizations. To date, there have been no fatalities. RDD is a safe and highly effective method for treating sensitized patients with the optimal pharmacologic agents. Its use should be expanded, but because patient safety is paramount, protocols must be created, reviewed, and overseen by allergist-immunologists with special training and experience in modern techniques of desensitization.

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Section: Rapid Drug Desensitization To Chemotherapeutic Agents: Taxanesmentioning

confidence: 98%

Desensitization regimens for drug allergy: state of the art in the 21st century

Liu

Fanning

Chong

et al. 2011

Clin Experimental Allergy

107

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“…One approach to improve its solubility is to formulate paclitaxel with a mixture of cremophor and dehydrated ethanol [3]. A concern of solubility of paclitaxel was solved by employing the Cremophor/ethanol formulation, which led to commercialization of paclitaxel as Taxol®; however, the low therapeutic index of paclitaxel still persists due to the inability to selectively target tumor tissues and side-effects of Cremophor/ethanol diluent [4]. A number of efforts attempted to derivatize paclitaxel into small molecular water-soluble pro-drugs [5-7] but have not been pursued toward clinical developments.…”

Section: Introductionmentioning

confidence: 99%

Clinically Relevant Anticancer Polymer Paclitaxel Therapeutics

Yang

Van

2010

Cancers

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The concept of utilizing polymers in drug delivery has been extensively explored for improving the therapeutic index of small molecule drugs. In general, polymers can be used as polymer-drug conjugates or polymeric micelles. Each unique application mandates its own chemistry and controlled release of active drugs. Each polymer exhibits its own intrinsic issues providing the advantage of flexibility. However, none have as yet been approved by the U.S. Food and Drug Administration. General aspects of polymer and nano-particle therapeutics have been reviewed. Here we focus this review on specific clinically relevant anticancer polymer paclitaxel therapeutics. We emphasize their chemistry and formulation, in vitro activity on some human cancer cell lines, plasma pharmacokinetics and tumor accumulation, in vivo efficacy, and clinical outcomes. Furthermore, we include a short review of our recent developments of a novel poly(l-γ-glutamylglutamine)-paclitaxel nano-conjugate (PGG-PTX). PGG-PTX has its own unique property of forming nano-particles. It has also been shown to possess a favorable profile of pharmacokinetics and to exhibit efficacious potency. This review might shed light on designing new and better polymer paclitaxel therapeutics for potential anticancer applications in the clinic.

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“…Docetaxel was initially presented as an alternative to paclitaxel due to the significant rate of hypersensitivity reactions; since the incorporation of docetaxel into treatment of breast, lung, and ovarian cancer, there have been observations that there was a significant decrease in the amount of hypersensitivity reactions. This observation has led people to believe that the hypersensitivity reaction might be caused by the diluent, Cremophor EL, as opposed to the chemotherapeutic agent itself [9, 11, 15]. If the reactions were caused by the taxane ring, which is the chemically reactive component of the chemotherapeutic agents, then the hypersensitivity reaction should be relatively equal with both paclitaxel and docetaxel.…”

Section: Discussionmentioning

confidence: 99%

Cremophor-Induced Lupus Erythematosus-Like Reaction with Taxol Administration: A Case Report and Review of the Literature

et al. 2011

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We report the first case of Cremophor EL-induced cutaneous lupus erythematosus-like reaction in a 40-year-old female undergoing treatment for breast cancer. There have been four reported cases of paclitaxel- and four cases of docetaxel-induced cutaneous lupus reactions in the published literature [Dasanu and Alexandrescu: South Med J 2008;101:1161–1162; Adachi and Horikawa: J Dermatol 2007;34:473–476; Lortholary et al: Presse Med 2007;36:1207–1208; Chen et al: J Rheumatol 2004;31:818–820]. Our patient developed findings of a cutaneous lupus-like reaction with administration of paclitaxel which was subsequently discontinued. She was re-challenged with albumin-bound paclitaxel which has no Cremophor EL compound in its formulation. This administration of albumin-bound paclitaxel did not induce further reaction. She did not develop a cutaneous lupus erythematosus-like reaction with three other subsequent administrations of albumin-bound paclitaxel. The diagnosis of lupus-like reaction in our patient was made based on the development of a malar butterfly rash sparing the nasolabial folds, the appearance of this rash in context of recently receiving treatments with paclitaxel, resolution of the rash after discontinuing the paclitaxel, and the presence of autoimmune antibodies in the patient’s serum which resolved with discontinuation of the paclitaxel. This is the first case demonstrating that the cause of the cutaneous lupus erythematosus-like reaction is not likely due to the taxane component of paclitaxel but the chemical composition of Cremophor EL. If the chemotherapeutic agent was causing the reaction then the same reaction should be seen by albumin-bound paclitaxel. We propose that previously reported lupus reactions may actually be due to Cremophor EL, which consists of polyoxyethylated castor oil, and not the chemotherapeutic agent itself.

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Paclitaxel hypersensitivity reactions: A role for docetaxel substitution

Cited by 26 publications

References 6 publications

Desensitization regimens for drug allergy: state of the art in the 21st century

Desensitization regimens for drug allergy: state of the art in the 21st century

Clinically Relevant Anticancer Polymer Paclitaxel Therapeutics

Cremophor-Induced Lupus Erythematosus-Like Reaction with Taxol Administration: A Case Report and Review of the Literature

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