Unexpected Anaphylaxis After Completing a Desensitization Protocol to Oxaliplatin: Successful Adjuvant Use of Omalizumab

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

“…Pretreatment with omalizumab may be considered when the measures previously described fail, although the quality of the evidence is low and many issues concerning optimal dose and pretreatment duration remain unanswered [144]. Some case reports have been published with carboplatin (3 patients) [145,146] and oxaliplatin (5 patients) [21,[147][148][149], with different approaches but common successful outcomes. In most of them 300 mg omalizumab was used, and at least 1 dose was administered before attempting desensitization.…”

Recent developments and highlights in drug hypersensitivity

“…Besides, 12‐ and 16‐step rapid desensitization protocols are effective and safe for biologicals and antineoplastic agents . Omalizumab has been used as adjuvant helping in the desensitization to oxaliplatin …”

“…15,176,181 Omalizumab has been used as adjuvant helping in the desensitization to oxaliplatin. 182 Premedications have been used to prevent reactions during desensitization. 89,183 Antihistamines and corticosteroids have shown to mask early signs of hypersensitivity, delaying treatment, 180 and their use is controversial because they provide a false sense of security in patients and physicians.…”

Modified protocol of omalizumab treatment to prevent carboplatin-induced drug hypersensitivity reactions: a case study

“…There is limited but growing experience using omalizumab for desensitisation of DHR; case‐reports or small case series describe positive results for aspirin [5 ], insulin [6 ], Elosulfase A, [7 ] and recently oxaliplatin [8 ]. Careful selection of patients remains pivotal and sufficient knowledge regarding the underlying pathogenic mechanism of the allergic reaction is essential.…”