Rapid Drug Desensitization with Chemotherapeutics (Platins, Taxanes, and Others): A Single-Center Retrospective Study

Kendirlinan, Reşat; Gümüşburun, Reyhan; Çerçi, Pamir; Özbek, Emre Anıl; Sözener, Zeynep Çelebi; Soyyiğit, Şadan; Aydın, Ömür; Bavbek, Sevim

doi:10.1159/000496745

Cited by 15 publications

(14 citation statements)

References 22 publications

(38 reference statements)

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“…In the literature, only three cases of irinotecan RDD are described without any reaction during the protocol unlike our case (Table 1; [6][7][8]).…”

Section: Discussionmentioning

confidence: 70%

Rapid protocol for irinotecan desensitization: a case report and literature review

et al. 2020

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“…In the literature, only three cases of irinotecan RDD are described without any reaction during the protocol unlike our case (Table 1; [6][7][8]).…”

Section: Discussionmentioning

confidence: 70%

Rapid protocol for irinotecan desensitization: a case report and literature review

et al. 2020

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“…Platinum compounds, such as carboplatin, were reported to have a higher BTR incidence than those of paclitaxel or monoclonal antibodies. 8 33 34 Carboplatin infusion through RDD was reported to cause grade 2 or higher BTR in 5% to 10%. 7 35 36 37 According to Sloane et al , 8 the BTR results of 1,069 desensitization therapies of carboplatin showed a similar rate to the BTR results of our study.…”

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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“…We used the same study method with chemotherapeutics and biologics as in our previous trial. 11 , 12 This study was approved by the local Ethics Committee (approval number: İ7-416-20). After the study was approved, informed consent was obtained from all participants.…”

Section: Methodsmentioning

confidence: 99%

“…As an experienced department in RDD, we provided one-to-one, desensitization-trained nursing care for each desensitization. 5 , 12 , 17 Written informed consent was obtained before each desensitization procedure.…”

Section: Methodsmentioning

confidence: 99%

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Rapid drug desensitization with platin-based chemotherapy: Analysis of risk factors for breakthrough reactions

Akin

Erkoç

Öztürk

et al. 2022

World Allergy Organization Journal

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Background All platin-based chemotherapeutics can cause hypersensitivity reactions (HSRs). With rapid drug desensitization (RDD), few patients experience breakthrough reactions (BTR) during desensitization. However, data about risk factors for BTRs during RDD in patients with HSRs to platins are limited. We first aimed to describe characteristics of our platin-reactive population and to validate the Brigham and Women's Hospital's (BWH's) RDD protocol in our population along with their outcomes with RDD. Our second aim was to identify the risk factors for BTRs. Method This was a retrospective chart review (2013–2020) of patients with symptoms of immediate HSRs to platins. Initial HSRs were classified as grade 1, 2, or 3 based on their severity. Skin prick tests (SPT)/intradermal tests (IDT) were performed with implicated platins. A 12-step protocol was used during RDD. Results The study comprised 65 women and seven men (mean age 57.78 ± 8.73 years). Initial HSRs to carboplatin, cisplatin, and oxaliplatin occurred in 38, 13, and 21 patients, respectively. All patients reacted at the fifth (median) recurrent infusions (min:1, max:20). The median values for carboplatin, cisplatin, and oxaliplatin were 6 (1–20), 3 (1–15), and 3 (1–11), respectively. Most initial HSRs were grade 2 (n = 40, 55.6%) and 3 (n = 27, 37.5%); only 6.9% (n = 5) were grade 1. Patients with grade 1, 2, and 3 initial HSRs had positive platin skin test results at rates of 80%, 74%, and 88%, respectively. A total of 232 RDDs were performed in 72 patients and 98.7% of these desensitizations were completed. BTRs occurred in 56 (24.1%) (grade 1 n = 14, 25%; grade 2 n = 32, 57%; grade 3 n = 10, 18%) of these desensitizations. Breakthrough reactions were more severe in patients with positive SPTs or 1:100 or 1:10 dilutions of IDT (p = 0.014). BTR was not observed during RDD in any of the patients with positive 1:1 dilutions of IDT. Positivity on prick or 1:100 or 1:10 IDT increased the risk of BTR 5.058 times. There was no significant association between the risk of BTRs and age, drug cycle, sex, comorbidities, or atopy. Conclusion In our experience, 98.7% of 232 RDDs to platins were completed successfully, showing that RDD was safe and effective. Drug skin test positivity is a potential marker for identifying high-risk patients who will have BTRs during RDDs to platins.

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Rapid Drug Desensitization with Chemotherapeutics (Platins, Taxanes, and Others): A Single-Center Retrospective Study

Cited by 15 publications

References 22 publications

Rapid protocol for irinotecan desensitization: a case report and literature review

Rapid protocol for irinotecan desensitization: a case report and literature review

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

Rapid drug desensitization with platin-based chemotherapy: Analysis of risk factors for breakthrough reactions

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