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Xiao D, Yang Z, Shi Y, Yang W, Zhang Y. Is a low dose of dexamethasone sufficient to prevent paclitaxel-related hypersensitivity reactions? A retrospective study in patients with gynecologic malignancy. Expert Rev Clin Pharmacol 2024; 17:525-532. [PMID: 38652518 DOI: 10.1080/17512433.2024.2343852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Paclitaxel hypersensitivity reactions (HSRs) are prevalent, especially in females. The common paclitaxel pretreatment, dexamethasone, may inhibit chemotherapy efficacy and accelerate tumor progression. We aimed to balance paclitaxel HSRs and the lowest dexamethasone dose for gynecologic malignancies. METHODS We retrospectively examined 1,074 cycles of 3-weekly paclitaxel-containing treatment for 231 gynecologic malignancies at Xiangya Hospital. HSR incidence with different dexamethasone regimens was the primary outcome. Risk factors were examined in all cycles using univariate and multivariate models with generalized estimating equations. A subgroup analysis of initial exposure to paclitaxel was also conducted. RESULTS HSR occurred in 33 patients (14.29%) and 49 cycles (4.56%), including 69.39% in cycles 1-2. There were no severe HSRs (grade ≥3). Different premedication regimens, including dexamethasone dosage and route, ranitidine presence or absence, didn't affect HSR incidence in univariate and multivariate analyzes (p > 0.05). Premenopausal women exerted fewer HSRs (ORadj 0.22, 95%CI 0.08-0.58; p = 0.002). At the first exposure to paclitaxel, more than 10 mg of dexamethasone didn't diminish HSRs (OR 0.83, 95%CI 0.27-2.59; p = 0.753). CONCLUSIONS In gynecologic malignancies, 10 mg dexamethasone along with 20 mg diphenhydramine may be adequate to prevent paclitaxel HSRs without ranitidine. It is necessary to reevaluate paclitaxel premedication regimens.
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Affiliation(s)
- Di Xiao
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, Hunan, China
| | - Zhiyun Yang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, Hunan, China
| | - Yin Shi
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- The Hunan Institute of Pharmacy Practice and Clinical Research, Changsha, Hunan, China
| | - Wenqing Yang
- Department of Gynecology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Gynecological Oncology Research and Engineering Center of Hunan Province, Changsha, Hunan, China
| | - Yu Zhang
- Department of Gynecology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Gynecological Oncology Research and Engineering Center of Hunan Province, Changsha, Hunan, China
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Barroso A, Estevinho F, Hespanhol V, Teixeira E, Ramalho-Carvalho J, Araújo A. Management of infusion-related reactions in cancer therapy: strategies and challenges. ESMO Open 2024; 9:102922. [PMID: 38452439 PMCID: PMC10937241 DOI: 10.1016/j.esmoop.2024.102922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Several anticancer therapies have the potential to cause infusion-related reactions (IRRs) in the form of adverse events that typically occur within minutes to hours after drug infusion. IRRs can range in severity from mild to severe anaphylaxis-like reactions. Careful monitoring at infusion initiation, prompt recognition, and appropriate clinical assessment of the IRR and its severity, followed by immediate management, are required to ensure patient safety and optimal outcomes. Lack of standardization in the prevention, management, and reporting of IRRs across cancer-treating institutions represents not only a quality and safety gap but also a disparity in cancer care. The present article, supported by recently published data, was developed to standardize these procedures across institutions and provide a useful tool for health care providers in clinical practice to recognize early signs and symptoms of an IRR and promptly and appropriately manage the event.
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Affiliation(s)
- A Barroso
- Multidisciplinary Unit of Thoracic Tumours, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - F Estevinho
- Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - V Hespanhol
- Departamento de Medicina Faculty of Medicine, University of Porto, Porto, Portugal; Department of Pulmonology, Centro Hospitalar de São João, Porto, Portugal
| | - E Teixeira
- Lung Cancer Unit, CUF Descobertas, Lisboa, Portugal
| | | | - A Araújo
- Medical Oncology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Oncology Research Unit, UMIB-Unit for Multidisciplinary Research in Biomedicine, ICBAS-School of Medicine and Biomedical Sciences, Universidade do Porto, Porto, Portugal.
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3
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Jao ME, Indorf AL, Segal EM, Miske A, Eaton KD, Marsolini T, Ghuman S. Impact of institutional interventions on the rate of paclitaxel hypersensitivity reactions. J Oncol Pharm Pract 2024; 30:105-111. [PMID: 37021579 DOI: 10.1177/10781552231168594] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
PURPOSE Paclitaxel is associated with hypersensitivity reactions (HSRs). Intravenous premedication regimens have been devised to decrease the incidence and severity of HSRs. At our institution oral histamine 1 receptor antagonists (H1RA) and histamine 2 receptor antagonists (H2RA) were adopted as standard. Standardizations were implemented for consistent premedication use in all disease states. The purpose of this retrospective study was to compare the incidence and severity of HSRs before and after standardization. METHODS Patients who received paclitaxel from 20 April 2018 to 8 December 2020 having an HSR were included in analysis. An infusion was flagged for review if a rescue medication was administered after the start of the paclitaxel infusion. The incidences of all HSR prior to and post-standardization were compared. A subgroup analysis of patients receiving paclitaxel for the first and second time was performed. RESULTS There were 3499infusions in the pre-standardization group and 1159infusions in the post-standardization group. After review, 100 HSRs pre-standardization and 38 HSRs post-standardization were confirmed reactions. The rate of overall HSRs was 2.9% in the pre-standardization group and 3.3% in the post-standardization group (p = 0.48). HSRs, during the first and second doses of paclitaxel, occurred in 10.2% of the pre-standardization and 8.5% of the post-standardization group (p = 0.55). CONCLUSIONS This retrospective interventional study demonstrated that same-day intravenous dexamethasone, oral H1RA, and oral H2RA are safe premedication regimens for paclitaxel. No change in the severity of reactions was seen. Overall, better adherence to premedication administration was seen post-standardization.
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Affiliation(s)
- Mark Edward Jao
- Department of Pharmacy, Fred Hutch Cancer Center, Seattle, WA, USA
| | - Amy Ly Indorf
- Department of Pharmacy, Fred Hutch Cancer Center, Seattle, WA, USA
| | | | - Abby Miske
- Department of Pharmacy, Fred Hutch Cancer Center, Seattle, WA, USA
| | | | - Trisha Marsolini
- Department of Pharmacy, Fred Hutch Cancer Center, Seattle, WA, USA
| | - Simran Ghuman
- Department of Pharmacy, Fred Hutch Cancer Center, Seattle, WA, USA
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Zwimpfer TA, Scherer K, Schötzau A, Heinzelmann‐Schwarz V, Hartmann K, Vetter M, Montavon C. Desensitization in patients with hypersensitivity to platinum and taxane in gynecological cancers. Cancer Med 2024; 13:e6840. [PMID: 38140783 PMCID: PMC10807606 DOI: 10.1002/cam4.6840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/29/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Exposure to paclitaxel and carboplatin has the risk of developing hypersensitivity reactions (HSRs), which could necessitate using less effective treatments to avoid anaphylaxis. Desensitization to platinum and taxane HSRs can be used to complete chemotherapy according to the standard regimen; therefore, this study investigated rates and benefits of successful desensitization in patients with gynecologic cancers (GC). METHODS We collected data from 241 patients with GC who had at least one cycle of platinum or taxane chemotherapy. The rate of HSRs and successful desensitization were evaluated, and an outcome analysis was conducted. RESULTS The rate of HSRs to platinum and taxane was 6.39% and 13.07%, respectively. We observed a 100% success rate of desensitization in our cohort. Patients with HSR were significantly younger (57.1 vs. 64.9 years, p = 0.030) in the taxane cohort. Importantly, the overall survival (OS) of patients with platinum and taxane HSRs who underwent desensitization was comparable to that of patients with no HSRs (platinum vs. controls; median OS 60.36 vs. 60.39 months, p = 0.31; taxane vs. controls; OS 80.29 vs. 60.00 months, p = 0.59). CONCLUSION Thus, we show that desensitization for platinum and taxane HSRs is safe and effective, resulting in an outcome that is well comparable to patients without HSR. Based on these observations, desensitization procedures might be considered as standard of care before switching to less effective treatment for patients with GC.
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Affiliation(s)
- Tibor A. Zwimpfer
- Department of Gynecology and Gynecological Oncology, Hospital for WomenUniversity Hospital BaselBaselSwitzerland
- Gynecological Cancer CenterUniversity Hospital BaselBaselSwitzerland
- Peter MacCallum Cancer CenterEast MelbourneVictoriaAustralia
| | - Kathrin Scherer
- Division of Allergy Unit, Department of DermatologyCantonal Hospital AarauAarauSwitzerland
| | - Andreas Schötzau
- Department of Gynecology and Gynecological Oncology, Hospital for WomenUniversity Hospital BaselBaselSwitzerland
| | - Viola Heinzelmann‐Schwarz
- Department of Gynecology and Gynecological Oncology, Hospital for WomenUniversity Hospital BaselBaselSwitzerland
- Gynecological Cancer CenterUniversity Hospital BaselBaselSwitzerland
| | - Karin Hartmann
- Department of DermatologyUniversity Hospital BaselBaselSwitzerland
| | - Marcus Vetter
- Cancer Center, Cantonal Hospital BasellandMedical University ClinicLiestalSwitzerland
| | - Céline Montavon
- Department of Gynecology and Gynecological Oncology, Hospital for WomenUniversity Hospital BaselBaselSwitzerland
- Gynecological Cancer CenterUniversity Hospital BaselBaselSwitzerland
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Villarreal-González RV, González-Díaz S, Vidal-Gutiérrez O, Canel-Paredes A, de la Cruz-de la Cruz C, García-Campa M, López-Méndez A, Alvarado-Ruiz S, Castells M. Hypersensitivity Reactions to Taxanes: A Comprehensive and Systematic Review of the Efficacy and Safety of Desensitization. Clin Rev Allergy Immunol 2023; 65:231-250. [PMID: 37589840 DOI: 10.1007/s12016-023-08968-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/18/2023]
Abstract
Taxanes in the treatment of cancer are associated with a significant incidence of hypersensitivity reactions, which may preclude their use in patients in need of first line therapy. Drug desensitization induces transient immunological tolerance and has allowed the reintroduction of taxanes in highly allergic patients. Increase the knowledge of hypersensitivity reactions (HSR) during the administration of taxanes. A systematic review regarding the safety and efficacy of rapid drug desensitization (RDD) for taxanes HSR. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was registered in PROSPERO(CRD42021242324) and a comprehensive search was conducted in Medline, Embase, Web of Science and Scopus databases. 25 studies encompassing 10 countries were identified and 976 patients with initial HSR to paclitaxel (n = 707) and docetaxel (n = 284), that underwent a total of 2,396 desensitizations. The most common symptoms were cutaneous (74.6%) with paclitaxel and respiratory (72.6%) with docetaxel. Severe initial hypersensitivity reactions including anaphylaxis occurred in 39.6% and 13% of paclitaxel and docetaxel cases respectively and during the first (87.4%) or second exposure (81.5%). Patients tolerated well RDD and breakthrough reactions (BTR) occurred in 32.2% of paclitaxel-treated patients and in 20.6% of docetaxel treated patients. Premedications included corticosteroids, antihistamines and leukotriene receptor antagonists. The most commonly used protocol was the BWH 3 bags 12 steps, all protocols showed a success rate between 95-100%, with no reported deaths. RDD is a safe and effective procedure in patients with HSR to taxanes and protocols should be standardized for wide range implementation.
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Affiliation(s)
- Rosalaura Virginia Villarreal-González
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Oncology Service. Centro Universitario Contra el Cáncer (CUCC), Monterrey, Nuevo León, México
| | - Sandra González-Díaz
- Faculty of Medicine, Regional Center of Allergy and Clinical Immunology, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr., José Eleuterio González", Monterrey, Nuevo León, México
| | - Oscar Vidal-Gutiérrez
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Oncology Service. Centro Universitario Contra el Cáncer (CUCC), Monterrey, Nuevo León, México
| | - Alejandra Canel-Paredes
- Instituto Tecnológico de Estudios Superiores de Monterrey ITESM, Monterrey, Nuevo León, México
| | - Carlos de la Cruz-de la Cruz
- Department of Internal Medicine. Monterrey, Universidad de Monterrey. Christus Muguerza Alta Especialidad, Nuevo León, México
| | - Mariano García-Campa
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr., José Eleuterio González", Monterrey, Nuevo León, México
| | - Alfonso López-Méndez
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr., José Eleuterio González", Monterrey, Nuevo León, México
| | - Sofía Alvarado-Ruiz
- Faculty of Medicine, Universidad Autónoma de Nuevo León, Hospital Universitario "Dr., José Eleuterio González", Monterrey, Nuevo León, México
| | - Mariana Castells
- Division of Allergy and Immunology, Department of Medicine, Brigham and Women's Hospital/Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
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6
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ALMuhizi F, De Las Vecillas Sanchez L, Gilbert L, Copaescu AM, Isabwe GAC. Premedication Protocols to Prevent Hypersensitivity Reactions to Chemotherapy: a Literature Review. Clin Rev Allergy Immunol 2022; 62:534-547. [PMID: 35258842 DOI: 10.1007/s12016-022-08932-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 12/19/2022]
Abstract
Hypersensitivity reactions (HSRs) to chemotherapy may prevent patients from receiving the most effective therapy. This review was undertaken to identify evidence-based preventive premedication strategies that reduce the likelihood of HSR in the first instance and improve the safety of subsequent infusions in patients who have demonstrated HSR to a certain class of chemotherapy. PubMed was searched until October 2021 using the key words: "hypersensitivity to chemotherapeutic drugs," "hypersensitivity to antineoplastic agents," "taxanes hypersensitivity," "platinum compound hypersensitivity," "premedication," "dexamethasone," "prednisone," "hydrocortisone," "antihistamine," "diphenhydramine," "cetirizine," "famotidine," "meperidine," "aspirin," "ibuprofen," and "montelukast." The search was restricted to articles published in English. A total of 73 abstracts were selected for inclusion in the review. Most premedication regimens have been derived empirically rather than determined through randomized trials. Based on the available evidence, we provide an update on likely HSR mechanisms and a practical guide for classifying systemic HSR. The evidence indicates that a combination of prevention strategies using newer antihistamines, H2 antagonists, leukotriene receptor antagonists, and corticosteroids and other interventions used judiciously reduces the occurrence and severity of HSR and improves safety.
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Affiliation(s)
- Faisal ALMuhizi
- Division of Allergy and Clinical Immunology, Department of Medicine, McGill University Health Centre (MUHC), McGill University, Montreal, QC, Canada.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Security Forces Hospital Program, Riyadh, Saudi Arabia
| | | | - Lucy Gilbert
- Department of Oncology, Obstetrics and Gynecology, McGill University Health Center (MUHC), McGill University, Montreal, QC, Canada
| | - Ana M Copaescu
- Division of Allergy and Clinical Immunology, Department of Medicine, McGill University Health Centre (MUHC), McGill University, Montreal, QC, Canada.,The Research Institute, McGill University Health Centre, McGill University, Montreal, QC, Canada.,Centre for Antibiotic Allergy and Research, Department of Infectious Diseases, Austin Health, Heidelberg, VIC, Australia
| | - Ghislaine A C Isabwe
- Division of Allergy and Clinical Immunology, Department of Medicine, McGill University Health Centre (MUHC), McGill University, Montreal, QC, Canada. .,The Research Institute, McGill University Health Centre, McGill University, Montreal, QC, Canada.
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7
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Dubinsky S, Patel D, Wang X, Srikanthan A, Ng TL, Tsang C. Pre-medication protocols for the prevention of paclitaxel-induced infusion related reactions: a systematic review and meta-analysis. Support Care Cancer 2022; 30:5627-5644. [PMID: 35150312 DOI: 10.1007/s00520-022-06891-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 01/31/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prophylaxis against infusion-related reactions (IRR) from paclitaxel with steroids and antihistamines is a standard of care due to high rates of IRR. This systematic review and meta-analysis aimed to comprehensively summarize the evidence behind various prophylaxis strategies. METHODS EMBASE, MEDLINE, PubMed, and the Cochrane Register of Controlled Trials were searched (1946 to May 14, 2021). The primary outcomes were Grade 3/4 IRR and any-grade IRR. Secondary outcomes included treatment delay or discontinuation and adverse events secondary to pre-medications. RESULTS Of the 1285 unique citations, 26 studies were selected: 11 studies for quantitative analysis and 15 studies for qualitative analysis. Studies included randomized controlled trials and observational studies (n = 25-281). There was a non-significant benefit in favour of oral steroids starting 12 h prior to paclitaxel administration versus intravenous steroids immediately prior to paclitaxel administration for grade 3/4 IRRs, with a risk difference (RD) of 2% [95%CI 0 to 5%], any-grade IRR with a RD of 4% [95%CI: -1% to 9%] and treatment discontinuation with a RD of 1% [95%CI -1% to 2%]. For de-escalation strategies, a point-estimate for any-grade IRR was 0.44% [95% CI, 0 to 0.02, p = 0.98] and for grade 3/4 IRR was 3.1% (95% CI, 0.02 to 0.07, p = 0.11). CONCLUSION Although studies have high risk of bias and risk, differences between steroid routes of administration were small, there was a non-significant trend in favour of oral steroids. De-escalation strategies after two previous successful paclitaxel infusions have an overall low incidence rate of severe IRR and warrant further prospective clinical trials. Insufficient evidence remains to recommend for or against other interventions for the prevention of paclitaxel IRR.
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Affiliation(s)
- Samuel Dubinsky
- Pharmacy Department, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada
| | - Deep Patel
- Pharmacy Department, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada
| | - Xiang Wang
- Pharmacy Department, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada
| | - Amirrtha Srikanthan
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada
- Department of Medical Oncology, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada
| | - Terry L Ng
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada
- Department of Medical Oncology, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada
| | - Corey Tsang
- Pharmacy Department, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada.
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8
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On J, Park HA, Yoo S. Development of a prediction models for chemotherapy-induced adverse drug reactions: A retrospective observational study using electronic health records. Eur J Oncol Nurs 2021; 56:102066. [PMID: 34861529 DOI: 10.1016/j.ejon.2021.102066] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/28/2021] [Accepted: 11/07/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE Chemotherapy-induced adverse drug reactions (ADRs) are common and diverse, and not only affect changes or interruptions to treatment schedules, but also negatively affect the patient's quality of life. This study aimed to predict eight chemotherapy-induced ADRs based on electronic health records (EHR) data using machine-learning algorithms. METHODS We used EHR data of 6812 chemotherapy cycles for 935 adult patients receiving four different chemotherapy regimens (FOLFOX, 5-fluorouracil + oxaliplatin + leucovorin; FOLFIRI, 5-fluorouracil + irinotecan + leucovorin; paclitaxel; and GP, gemcitabine + cisplatin) at a tertiary teaching hospital between January 2015 and June 2016. The predicted ADRs included nausea-vomiting, fatigue-anorexia, diarrhea, peripheral neuropathy, hypersensitivity, stomatitis, hand-foot syndrome, and constipation. Three machine learning algorithms were used to developed prediction models: logistic regression, decision tree, and artificial neural network. We compared the performance of the models with area of under the ROC (Receiver Operating Characteristic) curve (AUC) and accuracy. RESULTS The AUCs of the logistic regression, decision tree, and artificial neural network models were 0.62-0.83, 0.61-0.83, and 0.62-0.83, respectively, and the accuracies were 0.59-0.84, 0.55-0.88, and 0.57-0.88, respectively. Among the algorithms, the logistic regression models performed best and had the highest AUC for six ADRs (range 0.67-0.83). The nausea-vomiting prediction models performed best with an AUC of 0.83 for the three algorithms. CONCLUSIONS The prediction models for chemotherapy-induced ADRs were able to predict eight ADRs using EHR data. The logistic regression models were best suited to predict ADRs. The models developed in this study can be used to predict the risk of ADRs in patients receiving chemotherapy.
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Affiliation(s)
- Jeongah On
- College of Nursing, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
| | - Hyeoun-Ae Park
- College of Nursing, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea; Interdisciplinary Graduate Program of Medical Informatics, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
| | - Sooyoung Yoo
- Healthcare ICT Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
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9
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Abstract
Hypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions through an immunologic mechanism have been established for platinum and taxane agents, which are used to treat a wide variety of cancers including gynecologic cancers. Platin HSRs typically occur after multiple cycles of chemotherapy, reflecting the development of drug IgE sensitization, while taxane HSRs often occur on first or second exposure. Despite observed differences between platin and taxane HSRs, drug desensitization has been an effective method to reintroduce both chemotherapeutic agents safely. Skin testing is the primary diagnostic tool used to risk-stratify patients after initial HSRs, with more widespread use for platinum agents than taxanes. Different practices exist around the use of skin testing, drug challenge, and choice of desensitization protocol. Here, we review the epidemiology, mechanism, and clinical presentation of HSRs to platinum and taxane agents, as well as key controversies in their evaluation and management.
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10
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Predescu DV, Crețoiu SM, Crețoiu D, Alexandra Pavelescu L, Suciu N, Radu BM, Voinea SC. G Protein-Coupled Receptors (GPCRs)-Mediated Calcium Signaling in Ovarian Cancer: Focus on GPCRs activated by Neurotransmitters and Inflammation-Associated Molecules. Int J Mol Sci 2019; 20:ijms20225568. [PMID: 31703453 PMCID: PMC6888001 DOI: 10.3390/ijms20225568] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 11/05/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022] Open
Abstract
G-coupled protein receptors (GCPR) involve several signaling pathways, some of them being coupled with intracellular calcium (Ca2+) mobilization. GPCRs were involved in migration, invasion and metastasis of different types of cancers, including ovarian cancer. Many studies have discussed the essential contribution of GPCRs activated by steroid hormones in ovarian cancer. However, ovarian cancer is also associated with altered signals coming from the nervous system, the immune system or the inflammatory environment, in which GPCRs are ‘sensing’ these molecular signals. Many studies have been oriented so far on ovarian cell lines (most of them being of human cell lines), and only few studies based on animal models or clinical studies have been devoted to the expression changes or functional role of GPCRs in ovarian cancer. In this paper, we review the alterations of GPCRs activated by neurotransmitters (muscarinic receptors, serotonin receptors, dopamine receptors, adrenoceptors) or inflammation-associated molecules (bradykinin receptors, histamine receptors, chemokine receptors) in ovarian cancer and we discuss their potential as histological biomarkers.
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Affiliation(s)
- Dragoș-Valentin Predescu
- Department of General Surgery, Sf. Maria Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 37-39 Ion Mihalache Blvd., 011172 Bucharest, Romania
| | - Sanda Maria Crețoiu
- Department of Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
| | - Dragoș Crețoiu
- Department of Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute of Mother and Child Health, Polizu Clinical Hospital, 38-52 Gh. Polizu Street, 020395 Bucharest, Romania
| | - Luciana Alexandra Pavelescu
- Department of Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
| | - Nicolae Suciu
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute of Mother and Child Health, Polizu Clinical Hospital, 38-52 Gh. Polizu Street, 020395 Bucharest, Romania
- Department of Obstetrics and Gynecology, Alessandrescu-Rusescu National Institute of Mother and Child Health, Polizu Clinical Hospital, 38-52 Gh. Polizu Street, 020395 Bucharest, Romania
- Division of Obstetrics and Gynecology and Neonatology, Carol Davila University of Medicine and Pharmacy, Polizu Clinical Hospital, 38-52 Gh. Polizu Street, 020395 Bucharest, Romania
| | - Beatrice Mihaela Radu
- Department of Anatomy, Animal Physiology and Biophysics, Faculty of Biology, University of Bucharest, 91-95 Splaiul Independenţei, 050095 Bucharest, Romania
- Life, Environmental and Earth Sciences Division, Research Institute of the University of Bucharest (ICUB), University of Bucharest, 91-95 Splaiul Independenţei, 050095 Bucharest, Romania
- Correspondence: ; Tel.: +00-40-21-318-1573
| | - Silviu-Cristian Voinea
- Department of Surgical Oncology, Prof. Dr. Alexandru Trestioreanu Oncology Institute, Carol Davila University of Medicine and Pharmacy, 252 Fundeni Rd., 022328 Bucharest, Romania
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Parinyanitikul N, Tanpipattanakul W, Poovorawan N, Rattananupong T, Laoitthi P, Sithidetphaiboon P, Thanasanvimon S, Sriuranpong V. Incidence of infusion hypersensitivity reaction after withholding dexamethasone premedication in early breast cancer patients not experiencing two previous cycles of infusion hypersensitivity reaction for weekly paclitaxel chemotherapy. Support Care Cancer 2018; 26:2471-2477. [PMID: 29435713 DOI: 10.1007/s00520-018-4087-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 01/30/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Premedication with dexamethasone is an essential part of the prevention of hypersensitivity reaction (HSR) associated with taxane administration. However, the possibility of stopping dexamethasone premedication has been investigated in previous studies to reduce the steroid's adverse events; however, either the result or the particular protocol was limited. Thus, our study aimed to evaluate the incidence of HSR after dexamethasone premedication discontinuation after lack of HSR in two previous weekly paclitaxel infusions. METHOD Early breast cancer patients who received adjuvant weekly paclitaxel in a retrospective cohort from January 2012 through February 2016 at the King Chulalongkorn Memorial Hospital were reviewed. All patients received a standard premedication protocol prior to the first and second paclitaxel infusion. Dexamethasone was omitted in later cycles in all patients who did not undergo infusion HSR. Patients who developed HSR during the first or second cycles of paclitaxel infusion were excluded. The incidence of HSR during the later cycle of paclitaxel administration and factors associated with this adverse reaction were collected. RESULTS Eighty-one of 85 patients who did not undergo infusion HSR after 2 cycles of weekly paclitaxel administration were retrospectively reviewed. The median age was 51 years (range 27-74 years). Only 16% of the patients had a BMI greater than 30 kg/m2, 57.8% were premenopausal, 67.9% had no comorbidity, none had a history of allergy or asthma, 65.4% received weekly paclitaxel as a single agent, and 34.6% received weekly paclitaxel in combination with trastuzumab. Five of 81 patients reported grade I-II HSR (6.25%), which occurred mostly during the first 6 cycles (60%). Temporary discontinuation of paclitaxel infusion was observed in all HSR patients. No differences regarding age, BMI, menopausal status, and underlying disease between the HSR and no HSR groups were identified. Concerning the safety profile, peripheral neuropathy (gr I 60%, gr II 13.5%, and gr III 2.4%), myalgia (43.4%), and edema (10.5%) were commonly reported, whereas dyspepsia (5.3%) and insomnia (14.5%) were rarely described in withholding patients. CONCLUSION Withholding dexamethasone premedication in non-experiencing HSR patients after two previous cycles of weekly paclitaxel administration was safe and did not impact the higher incidence of HSR. A discontinuing dexamethasone protocol should be recommended generally in these patients, especially those with a high risk for steroid-induced side effects.
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Affiliation(s)
- Napa Parinyanitikul
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
| | - Walailuk Tanpipattanakul
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Nattaya Poovorawan
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Thanapoom Rattananupong
- Department of Preventive Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Poranee Laoitthi
- Department of Preventive Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Piyada Sithidetphaiboon
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Suebpong Thanasanvimon
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Virote Sriuranpong
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Is there any predictor for hypersensitivity reactions in gynecologic cancer patients treated with paclitaxel-based therapy? Cancer Chemother Pharmacol 2017; 80:65-69. [DOI: 10.1007/s00280-017-3332-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/02/2017] [Indexed: 10/19/2022]
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Tanpipattanakul W, Poovorawan N, Rattananupong T, Laoitthi P, Sithidetphaiboon P, Thanasanvimon S, Sriuranpong V, Parinyanitikul N. Feasibility of withholding dexamethasone premedication for hypersensitivity reactions associated with paclitaxel administration. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.1004.500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Premedication with dexamethasone is crucial to prevent hypersensitivity reactions (HSR) associated with administration of taxanes. However, high dose and prolonged exposure to dexamethasone may cause adverse effects.
Objectives
To determine the incidence of HSR in patients with early breast cancer who did or did not receive dexamethasone prophylaxis for weekly paclitaxel infusions.
Methods
We retrospectively reviewed the records of a cohort of patients with early breast cancer who received paclitaxel weekly from January 2012 through March 2015 at King Chulalongkorn Memorial Hospital. All patients received a standard premedication protocol including dexamethasone before their first paclitaxel infusion. Dexamethasone was omitted in later cycles in some patients at the discretion of the attending physician. Data concerning the baseline characteristics of the patient, details of the premedication protocol, including dose and schedule of dexamethasone, and HSR events were collected in this observational study.
Results
Data were drawn from 86 breast cancer patients (median age 52.6 years) treated with a total of 984 cycles of paclitaxel chemotherapy. No patient had any history of allergy or HSR to taxanes. Dexamethasone was omitted in 617 later cycles. Six patients had grade II-III HSR (7.0%), which occurred mostly during the first 6 cycles (5/6, 83.3%). The incidence of HRS was 3/367 cycles (0.82%) with dexamethasone premedication (P = 0.99) and 5/617 (0.81%) without.
Conclusions
Withholding dexamethasone premedication for paclitaxel chemotherapy was feasible, and did not result in a higher incidence of HSR. However, an optimal schedule for dexamethasone warrants investigation in a prospective manner.
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Affiliation(s)
- Walailuk Tanpipattanakul
- Division of Medical Oncology , Department of Medicine , Faculty of Medicine , Chulalongkorn University and the King Chulalongkorn Memorial Hospital , Bangkok 10330 , Thailand
| | - Nattaya Poovorawan
- Division of Medical Oncology , Department of Medicine , Faculty of Medicine , Chulalongkorn University and the King Chulalongkorn Memorial Hospital , Bangkok 10330 , Thailand
| | - Thanapoom Rattananupong
- Department of Preventive Medicine , Faculty of Medicine , Chulalongkorn University and the King Chulalongkorn Memorial Hospital , Bangkok 10330 , Thailand
| | - Poranee Laoitthi
- Department of Preventive Medicine , Faculty of Medicine , Chulalongkorn University and the King Chulalongkorn Memorial Hospital , Bangkok 10330 , Thailand
| | - Piyada Sithidetphaiboon
- Division of Medical Oncology , Department of Medicine , Faculty of Medicine , Chulalongkorn University and the King Chulalongkorn Memorial Hospital , Bangkok 10330 , Thailand
| | - Suebpong Thanasanvimon
- Division of Medical Oncology , Department of Medicine , Faculty of Medicine , Chulalongkorn University and the King Chulalongkorn Memorial Hospital , Bangkok 10330 , Thailand
| | - Virote Sriuranpong
- Division of Medical Oncology , Department of Medicine , Faculty of Medicine , Chulalongkorn University and the King Chulalongkorn Memorial Hospital , Bangkok 10330 , Thailand
| | - Napa Parinyanitikul
- Division of Medical Oncology , Department of Medicine , Faculty of Medicine , Chulalongkorn University and the King Chulalongkorn Memorial Hospital , Bangkok 10330 , Thailand
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Yanaranop M, Chaithongwongwatthana S. Intravenous versus oral dexamethasone for prophylaxis of paclitaxel-associated hypersensitivity reaction in patients with primary ovarian, fallopian tube and peritoneal cancer: A double-blind randomized controlled trial. Asia Pac J Clin Oncol 2016; 12:289-99. [PMID: 27098551 DOI: 10.1111/ajco.12495] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2016] [Indexed: 11/30/2022]
Abstract
AIM To compare the efficacies and side effects of intravenous and oral dexamethasone (IV-D and PO-D) for paclitaxel-associated hypersensitivity reaction (P-HSR) prophylaxis in patients with primary ovarian, fallopian tube and peritoneal carcinomas (POC/PFTC/PPC) receiving a first cycle of paclitaxel plus carboplatin (TC). METHODS In this double-blind randomized controlled trial, patients with POC/PFTC/PPC receiving a first cycle of TC were randomly allocated in a 1:1 ratio to either the IV-D or PO-D groups. Those were followed at 28 days. Primary outcomes were incidence of overall and severe P-HSRs. Secondary outcomes included incidence of dexamethasone-related side effects, other chemotherapy-related adverse events (AEs), and quality-of-life (QoL). RESULTS A total of 288 patients were enrolled from February to July 2015, of whom 281 were eligible for analysis, including 140 allocated to IV-D and 141 to PO-D. There was no significant difference in P-HSR rate between the IV-D and PO-D groups (17.9% vs. 19.1%, P = 0.780). Severe P-HSR occurred in one women in the IV-D group (0.7% vs. 0%, P = 0.498). There were no significant differences in other chemotherapy-related AEs and QoL scores. However, women in the PO-D had more side effects from short-term corticosteroid use than those in the IV-D group, especially acne (10.6% vs. 2.1%, P = 0.004). CONCLUSIONS IV-D and PO-D have similar efficacies for preventing P-HSR. However, short-term IV-D may be associated with fewer side effects than PO-D. IV-D is thus suggested for P-HSR prophylaxis in patients with POC/PFTC/PPC receiving a first cycle of TC.
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Affiliation(s)
- Marut Yanaranop
- Department of Obstetrics and Gynecology, Rajavithi Hospital.,College of Medicine, Rangsit University
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15
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Adverse events to nontargeted and targeted chemotherapeutic agents: emphasis on hypersensitivity responses. Immunol Allergy Clin North Am 2015; 34:565-96, viii. [PMID: 25017678 DOI: 10.1016/j.iac.2014.04.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Use of cytotoxic agents is associated with potential hypersensitivity reactions which are common with platinum compounds, L-asparaginase, taxanes, procarbazine and epipodophyllotoxins. Mechanisms underlying the reactions may involve IgE, non-allergic or a number of pathogenetically unclear events. Targeted therapies produce less collateral damage but demonstrate their own unique reactions. Cytopenias occur less often and mucocutaneous reactions to EGFR inhibitors, including papulopustular rash, are common. Fifteen currently approved mAbs provoke all four types of hypersensitivities including immune cytopenias, vasculitis, serum sickness and pulmonary events. Some successful desensitization protocols have been developed. Prevention of hypersensitivity reactions is based on skin testing, premedication and/or desensitization.
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16
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Tham EH, Cheng YK, Tay MH, Alcasabas AP, Shek LPC. Evaluation and management of hypersensitivity reactions to chemotherapy agents. Postgrad Med J 2015; 91:145-50. [PMID: 25659930 DOI: 10.1136/postgradmedj-2014-132686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hypersensitivity reactions to chemotherapy drugs pose significant difficulties in management, especially when no suitable alternative is available or acceptable and delay in continuation of treatment may be life-threatening. Such reactions may be IgE- or non-IgE-mediated and have varied manifestations. Timely recognition and treatment of life-threatening hypersensitivity reactions are essential. Identification of patients at high risk of developing hypersensitivity reactions allows risk stratification to guide clinical decision-making. Skin testing for carboplatin hypersensitivity has good predictive value but is not yet established for oxaliplatin and taxane hypersensitivity. Rapid desensitisation may be considered if no suitable alternative drug is available. Available protocols have shown good safety and efficacy but must be performed in an appropriate setting with adequate monitoring. There are many avenues for research into the utility of skin testing for other chemotherapy agents as well as in vitro tests.
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Affiliation(s)
- Elizabeth Huiwen Tham
- University Children's Medical Institute, National University Hospital, Singapore, Singapore Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yew Kuang Cheng
- Department of Allergy, Arthritis & Rheumatism Clinic, Gleneagles Medical Centre, Singapore, Singapore
| | - Miah Hiang Tay
- Oncocare Clinic, Gleneagles Medical Centre, Singapore, Singapore
| | - Ana Patricia Alcasabas
- University Children's Medical Institute, National University Hospital, Singapore, Singapore Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lynette Pei-Chi Shek
- University Children's Medical Institute, National University Hospital, Singapore, Singapore Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Boulanger J, Boursiquot JN, Cournoyer G, Lemieux J, Masse MS, Almanric K, Guay MP. Management of hypersensitivity to platinum- and taxane-based chemotherapy: cepo review and clinical recommendations. ACTA ACUST UNITED AC 2014; 21:e630-41. [PMID: 25089112 DOI: 10.3747/co.21.1966] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although antineoplastic agents are critical in the treatment of cancer, they can potentially cause hypersensitivity reactions that can have serious consequences. When such a reaction occurs, clinicians can either continue the treatment, at the risk of causing a severe or a potentially fatal anaphylactic reaction, or stop the treatment, although it might be the only one available. The objective of the present work was to evaluate the effectiveness of methods used to prevent and treat hypersensitivity reactions to platinum- or taxane-based chemotherapy and to develop evidence-based recommendations. METHODS The scientific literature published to December 2013, inclusive, was reviewed. RESULTS Premedication with antihistamines, H2 blockers, and corticosteroids is not effective in preventing hypersensitivity reactions to platinum salts. However, premedication significantly reduces the incidence of hypersensitivity to taxanes. A skin test can generally be performed to screen for patients at risk of developing a severe reaction to platinum salts in the presence of grade 1 or 2 reactions, but skin testing does not appear to be useful for taxanes. A desensitization protocol allows for re-administration of either platinum- or taxane-based chemotherapy to some patients without causing severe hypersensitivity reactions. CONCLUSIONS Several strategies such as premedication, skin testing, and desensitization protocols are available to potentially allow for administration of platinum- or taxane-based chemotherapy to patients who have had a hypersensitivity reaction and for whom no other treatment options are available. Considering the available evidence, the Comité de l'évolution des pratiques en oncologie made recommendations for clinical practice in Quebec.
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Affiliation(s)
- J Boulanger
- Institut national d'excellence en santé et services sociaux ( inesss ), Quebec City, QC
| | - J N Boursiquot
- Centre hospitalier de l'Université Laval ( chu de Québec), Quebec City, QC
| | - G Cournoyer
- Hôpital régional de Saint-Jérôme ( csss de Saint-Jérôme), Saint-Jérôme, QC
| | - J Lemieux
- Hôpital du Saint-Sacrement ( chu de Québec), Quebec City, QC
| | - M S Masse
- Hôpital Notre-Dame ( chum ), Montreal, QC
| | - K Almanric
- Hôpital de la Cité-de-la-Santé ( csss de Laval), Laval, QC
| | - M P Guay
- Jewish General Hospital, Montreal, QC
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Picard M, Castells MC. Re-visiting Hypersensitivity Reactions to Taxanes: A Comprehensive Review. Clin Rev Allergy Immunol 2014; 49:177-91. [DOI: 10.1007/s12016-014-8416-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Piovano E, Pivetta E, Modaffari P, Martra F, Baima Poma C, Perotto S, Tripodi E, Zanfagnin V, Zola P, Ferrero A. A Search for Predictive Factors for Hypersensitivity Reactions to Paclitaxel and Platinum Salts in Chemotherapy for Gynecologic Pelvic Neoplasms. Gynecol Obstet Invest 2012; 74:21-7. [DOI: 10.1159/000336772] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 01/24/2012] [Indexed: 11/19/2022]
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20
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Kim HK, Kim SW, Kang HW, Kwon KJ, Park HS, Ryu YJ, Lee JH, Chun EM, Cho YJ, Chang JH. A Case of Delayed Severe Hypersensitivity Reaction during Genexol-PM® Infusion. Tuberc Respir Dis (Seoul) 2010. [DOI: 10.4046/trd.2010.68.5.294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hyun Kyung Kim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Su Woo Kim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hye Won Kang
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyoung Joo Kwon
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hye Sung Park
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yon Ju Ryu
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jin Hwa Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Eun Mi Chun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Young Joo Cho
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jung Hyun Chang
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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Gemici G, Cinçin A, Değertekin M, Oktay A. Paclitaxel-induced ST-segment elevations. Clin Cardiol 2009; 32:E94-6. [PMID: 19382279 PMCID: PMC6653473 DOI: 10.1002/clc.20291] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Accepted: 08/24/2007] [Indexed: 11/08/2022] Open
Abstract
A 51-year-old woman presented with severe chest pain minutes after starting intravenous paclitaxel as a part of the systemic chemotherapy due to ovarian carcinoma. The electrocardiogram (ECG) revealed sinus rhythm with ST-segment elevations in inferior and anterior leads. The ST-segment elevations resolved immediately after sublingual nitroglycerine. Cardiac troponin T and CPK MB levels remained in the normal range at repeat measurements. It was presumed that in spite of standard premedication, paclitaxel had induced acute coronary syndrome with ST-segment elevations in this patient.
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Isonishi S, Suzuki M, Hirama M, Matsumoto R, Ochiai K, Tanaka T. Use of Docetaxel After Paclitaxel Hypersensitivity Reaction in Epithelial Ovarian and Endometrial Cancer. ACTA ACUST UNITED AC 2009. [DOI: 10.3816/coc.2009.n.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Arimoto T, Nakagawa S, Yasugi T, Yoshikawa H, Kawana K, Yano T, Taketani Y. Treatment with paclitaxel plus carboplatin, alone or with irradiation, of advanced or recurrent endometrial carcinoma. Gynecol Oncol 2007; 104:32-5. [PMID: 16996113 DOI: 10.1016/j.ygyno.2006.07.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2006] [Revised: 07/05/2006] [Accepted: 07/06/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The goal of this study was to evaluate the efficacy and toxicity of paclitaxel plus carboplatin in the treatment of primarily advanced or recurrent endometrial carcinoma. METHODS Thirty-seven consecutive patients with advanced or recurrent endometrial carcinoma were enrolled in this study. Paclitaxel at a dose of 175 mg/m(2) was administered intravenously over 3 h followed by carboplatin with area under the curve of 5 to 6 over 1 h at 4-week intervals. Five patients were received 50 Gy pelvic irradiation, and 7 were received 50 Gy pelvic and 50 Gy paraaortic irradiation, after adjuvant chemotherapy with paclitaxel plus carboplatin. Eighteen patients had evaluable lesions. Responses were assessed before the use of any irradiation. RESULTS Eleven patients (61%) achieved an objective response, including one complete response (5.6%) and 10 partial responses (56%). The most common toxicity was hematologic: grade 3 or 4 leukopenia and neutropenia occurred in 59% and 86% of patients, respectively. Three patients (8%) required granulocyte colony-stimulating factor support. One patient required a platelet transfusion, and four required blood transfusions. There was a single adverse event of anaphylaxis. CONCLUSION The combination of paclitaxel and carboplatin appears to be an effective regimen for the treatment of patients with advanced or recurrent endometrial carcinoma with tolerable toxicity.
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Affiliation(s)
- Takahide Arimoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Tokyo 113-8655, Japan
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Yahata H, Saito M, Sendo T, Itoh Y, Uchida M, Hirakawa T, Nakano H, Oishi R. Prophylactic effect of pemirolast, an antiallergic agent, against hypersensitivity reactions to paclitaxel in patients with ovarian cancer. Int J Cancer 2006; 118:2636-8. [PMID: 16353140 DOI: 10.1002/ijc.21680] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We have previously shown that sensory nerve peptides contribute to the pathogenesis of pulmonary hypersensitivity reactions (HSRs) to paclitaxel in rats. Moreover, pemirolast, an antiallergic agent, reverses the HSRs to paclitaxel, although the mechanism is considered to result from the blockade of paclitaxel-induced release of sensory peptides, rather than the inhibition of histamine release. In the present study, we investigated the preventive effect of pemirolast against acute HSRs in a total of 84 patients who undertook postoperative paclitaxel plus carboplatin chemotherapy every 4 weeks for ovarian cancer. Patients were assigned to receive oral lactose (placebo) or pemirolast (10 mg), 2 hr before paclitaxel infusion. All patients received conventional premedication, including oral diphenhydramine, intravenous ranitidine and intravenous dexamethasone, 30 min before paclitaxel infusion. The HSRs that led to the discontinuance of paclitaxel infusion (grade>or=2) occurred in 5 of 42 patients in placebo group, whereas none of pemirolast-treated 42 patients showed any signs of HSRs. Plasma histamine concentrations were not changed after paclitaxel infusion in either group. Our present findings suggest that pemirolast is potentially useful for prophylaxis of paclitaxel-induced HSRs. In this respect, the use of pemirolast as premedication is expected to be beneficial to the safety management in patients who undergo chemotherapy containing paclitaxel.
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Affiliation(s)
- Hideaki Yahata
- Department of Obstetrics and Gynecology Medicine, Kyushu University Graduate School of Medical Sciences, and Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan
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