Desensitization effective, safe in patients with hypersensitivity reactions to chemotherapy

Total dose desensitization is successful in patients with hypersensitivity reactions (HSRs) to chemotherapy, suggests a study.

HSRs to paclitaxel tend to occur during the first two cycles and to carboplatin after six cycles. Some of the HSR symptoms include cardiovascular, atypical neuromuscular, and urticaria.

Furthermore, “[c]hanging treatment lines impacts prognosis,” the authors said.

This study included patients with gynaecological tumours, aged >18 years, experiencing HSRs to first-line chemotherapy. The participants underwent three-bags 12-step desensitization.

Thirty-three female patients (mean age 45.5 years) underwent a total of 174 desensitization (95 paclitaxel, 79 carboplatin). Of these, eight (24.2 percent) had breast cancer, 14 (42.2 percent) ovarian, two (6.1 percent) endometrial, and nine (27.2 percent) cervical. HSR manifested during cycles 1‒2 in paclitaxel and after six cycles in carboplatin.

The most common HSR symptoms observed were cardiovascular with paclitaxel (94.7 percent) and cutaneous with carboplatin (93.3 percent).

All patients successfully reached total dose desensitization, of whom 82 percent had no reaction, 12 percent had mild reaction, 6 percent had moderate reaction, and 0 percent had severe reaction.

The respective mean disease-free interval and progression free interval were 29 and 14 months in breast cancer, 22 and 9 months in ovarian cancer, 40 months in endometrial cancer, and 67.5 and 27 months in cervical cancer. Of the patients, 25 (73.5 percent) are still alive.

“Our study revealed that ovarian cancer patients undergoing desensitization protocols achieved longer progression-free intervals,” the authors said.

“This study provides evidence of the effectiveness and safety of desensitization and promising perspective for continuing first-line treatment with HSRs,” they added.