1
|
Chen X, Ou S, Luo J, He Z, Jiang Q. Advancing perspectives on the off-label use of anticancer drugs: an updated classification and exploration of categories. Front Pharmacol 2024; 15:1374549. [PMID: 38898925 PMCID: PMC11186405 DOI: 10.3389/fphar.2024.1374549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/13/2024] [Indexed: 06/21/2024] Open
Abstract
To date, the definition that the off-label usage of drugs refers to the unapproved use of approved drugs, which covers unapproved indications, patient populations, doses, and/or routes of administration, has been in existence for many years. Currently, there is a limited frequency and prevalence of research on the off-label use of antineoplastic drugs, mainly due to incomplete definition and classification issues. It is time to embrace new categories for the off-label usage of anticancer drugs. This review provided an insight into an updated overview of the concept and categories of the off-label use of anticancer drugs, along with illustrating specific examples to establish the next studies about the extent of the off-label usage of anticancer drugs in the oncology setting. The scope of the off-label use of current anticancer drugs beyond the previous definitions not only includes off-label uses in terms of indications, patient populations, doses, and/or routes of administration but also off-label use in terms of medication course, combination, sequence of medication, clinical purpose, contraindications scenarios, etc. In addition, the definition of the off-label usage of anticancer drugs should be added to the condition at a given time, and it varies from approval authorities. We presented a new and relatively comprehensive classification, providing extensive analysis and illustrative examples of the off-label usage of antineoplastic drugs for the first time. Such a classification has the potential to promote practical adoption and enhance management strategies for the off-label use of antitumor drugs.
Collapse
Affiliation(s)
- Xiaoyi Chen
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Shunlong Ou
- Department of Pharmacy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jing Luo
- Department of Pharmacy, The Second People’s Hospital of Yibin, Yibin, Sichuan, China
| | - Zhisan He
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Qian Jiang
- Department of Pharmacy, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| |
Collapse
|
2
|
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.
Collapse
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.
| |
Collapse
|
3
|
Doña I, Torres MJ, Celik G, Phillips E, Tanno LK, Castells M. Changing patterns in the epidemiology of drug allergy. Allergy 2024; 79:613-628. [PMID: 38084822 DOI: 10.1111/all.15970] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/23/2023] [Accepted: 11/26/2023] [Indexed: 03/01/2024]
Abstract
Drug allergy (DA) remains a complex and unaddressed problem worldwide that often deprives patients of optimal medication choices and places them at risk for life-threatening reactions. Underdiagnosis and overdiagnosis are common and due to the lack of standardized definitions and biomarkers. The true burden of DA is unknown, and recent efforts in data gathering through electronic medical records are starting to provide emerging patterns around the world. Ten percent of the general population engaged in health care claim to have a DA, and the most common label is penicillin allergy. Up to 20% of emergency room visits for anaphylaxis are due to DA and 15%-20% of hospitalized patients report DA. It is estimated that DA will increase based on the availability and use of new and targeted antibiotics, vaccines, chemotherapies, biologicals, and small molecules, which are aimed at improving patient's options and quality of life. Global and regional variations in the prevalence of diseases such as human immunodeficiency virus and mycobacterial diseases, and the drugs used to treat these infections have an impact on DA. The aim of this review is to provide an update on the global impact of DA by presenting emerging data on drug epidemiology in adult and pediatric populations.
Collapse
Affiliation(s)
- Immaculada Doña
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Malaga, Spain
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain
| | - Maria Jose Torres
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Malaga, Spain
- Allergy Unit, Hospital Regional Universitario de Málaga, Malaga, Spain
- Departamento de Medicina, Universidad de Málaga, Malaga, Spain
| | - Gulfem Celik
- Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Elizabeth Phillips
- Department of Medicine, Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
| | - Luciana Kase Tanno
- Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier, France
- Desbrest Institute of Epidemiology and Public Health, UMR UA11 University of Montpellier-INSERM, Montpellier, France
- WHO Collaborating Centre on Scientific Classification Support, Montpellier, France
| | - Mariana Castells
- Division of Allergy and Immunology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Villarreal-González RV, Canel-Paredes A, Arias-Cruz A, Fraga-Olvera A, Delgado-Bañuelos A, Rico-Solís GA, Ochoa-García IV, Jiménez-Sandoval JO, Ramírez-Heredia J, Flores-González JV, Cortés-Grimaldo RM, Zecua-Nájera Y, Ortega-Cisneros M. [Drug allergy: Fundamental aspects in diagnosis and treatment.]. REVISTA ALERGIA MÉXICO 2023; 69:195-213. [PMID: 37218047 DOI: 10.29262/ram.v69i4.1181] [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] [Received: 10/26/2022] [Accepted: 02/14/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Any substance used as a treatment for any disease can produce harmful or unpleasant events called adverse drug reactions (ADRs). They are due to inherent biological effects of the drug and are caused by immunological and non-immunological mechanisms. OBJECTIVES To describe the immunological mechanisms of hypersensitivity reactions (HSR) to drugs, their epidemiology, risk factors, classification, clinical manifestations, diagnosis, treatment, and prognosis. METHODS A review of the most current literature in English and Spanish was carried out, in the main databases, related to the HSR of various drug groups. RESULTS This study describes the terms used to define ADRs and HSRs, their classification and clinical manifestations, current diagnostic tools, treatment algorithms and prognosis of the most frequently used medications and with the highest prevalence of reported adverse events. CONCLUSION ADRs are a challenging entity, with a complex pathophysiology that has not been fully understood. Its approach requires a careful consideration since not all drugs have validated tests for their diagnosis nor a specific treatment. When indicating the use of any drug, the severity of the disease, the availability of other treatments and the potential risks of developing future adverse events should always be taken into consideration.
Collapse
Affiliation(s)
- Rosalaura Virginia Villarreal-González
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Servicio de Alergia e Inmunología Clínica, Hospital Universitario Dr. José Eleuterio González, Nuevo León, México
| | - Alejandra Canel-Paredes
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Servicio de Alergia e Inmunología Clínica, Hospital Universitario Dr. José Eleuterio González, Nuevo León, México
| | - Alfredo Arias-Cruz
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Servicio de Alergia e Inmunología Clínica, Hospital Universitario Dr. José Eleuterio González, Nuevo León, México
| | - Alira Fraga-Olvera
- Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México; Hospital Amerimed, Quintana Roo, México
| | - Angélica Delgado-Bañuelos
- Servicio de Alergia e Inmunología Clínica, Hospital General Regional 58, Instituto Mexicano del Seguro Social, Guanajuato, México
| | | | - Itzel Vianey Ochoa-García
- Departamento de Inmunología clínica y Alergia, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Jalisco, México
| | - Jaime Omar Jiménez-Sandoval
- Departamento de Alergia e Inmunología Clínica, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México; Hospital Regional Río Blanco, SESVER, Veracruz, México
| | - Jennifer Ramírez-Heredia
- Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México; Hospital MAC, Irapuato, Guanajuato, México
| | | | - Rosa María Cortés-Grimaldo
- Departamento de Alergia e Inmunología Clínica, Unidad Médica de Alta Especialidad, Hospital de Pediatría del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Jalisco, México
| | - Yahvéh Zecua-Nájera
- Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México; Centro Médico San Carlos, Tlaxcala, México
| | - Margarita Ortega-Cisneros
- Departamento de Inmunología Clínica y Alergia, Unidad Médica de Alta Especialidad, Hospital de especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social.
| |
Collapse
|
5
|
Pagani M, Bavbek S, Alvarez‐Cuesta E, Berna Dursun A, Bonadonna P, Castells M, Cernadas J, Chiriac A, Sahar H, Madrigal‐Burgaleta R, Sanchez Sanchez S. Hypersensitivity reactions to chemotherapy: an EAACI Position Paper. Allergy 2022; 77:388-403. [PMID: 34587281 DOI: 10.1111/all.15113] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 03/30/2021] [Accepted: 08/27/2021] [Indexed: 12/19/2022]
Abstract
Chemotherapeutic drugs have been widely used in the treatment of cancer disease for about 70 years. The development of new treatments has not hindered their use, and oncologists still prescribe them routinely, alone or in combination with other antineoplastic agents. However, all chemotherapeutic agents can induce hypersensitivity reactions (HSRs), with different incidences depending on the culprit drug. These reactions are the third leading cause of fatal drug-induced anaphylaxis in the United States. In Europe, deaths related to chemotherapy have also been reported. In particular, most reactions are caused by platinum compounds, taxanes, epipodophyllotoxins and asparaginase. Despite their prevalence and relevance, the ideal pathways for diagnosis, treatment and prevention of these reactions are still unclear, and practice remains considerably heterogeneous with vast differences from center to center. Thus, the European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology organized a task force to provide data and recommendations regarding the allergological work-up in this field of drug hypersensitivity reactions. This position paper aims to provide consensus on the investigation of HSRs to chemotherapeutic drugs and give practical recommendations for clinicians that treat these patients, such as oncologists, allergologists and internists. Key sections cover risk factors, pathogenesis, symptoms, the role of skin tests, in vitro tests, indications and contraindications of drug provocation tests and desensitization of neoplastic patients with allergic reactions to chemotherapeutic drugs. Statements, recommendations and unmet needs were discussed and proposed at the end of each section.
Collapse
Affiliation(s)
- Mauro Pagani
- Department of Medicine Medicine Ward C. Poma Mantova HospitalASST Mantova Mantova Italy
| | - Sevim Bavbek
- Division of Immunology and Allergy Department of Chest Diseases Ankara University School of Medicine Ankara Turkey
| | | | - Adile Berna Dursun
- Department of Immunology and Allergic Diseases Recep Tayyip Erdoğan University Rize Turkey
| | | | - Mariana Castells
- Division of Rheumatology, Immunology and Allergy Department of Medicine Brigham and Women's HospitalHarvard Medical School Boston Massachusetts USA
| | - Josefina Cernadas
- Department of Allergy and Clinical Immunology Medical University, H. S. Joao Porto Portugal
| | - Anca Chiriac
- Division of Allergy Department of Pulmonology Hôpital Arnaud de VilleneuveUniversity Hospital of Montpellier Montpellier France
| | - Hamadi Sahar
- The Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA
| | - Ricardo Madrigal‐Burgaleta
- Allergy & Severe Asthma Service St Bartholomew's Hospital'sBarts Health NHS Trust London UK
- Drug Desensitisation Centre Catalan Institute of Oncology (ICO) Bellvitge University Hospital Barcelona Spain
| | - Soledad Sanchez Sanchez
- Division of Allergy & Clinical Immunology Department of Medicine University Hospital Complex of A Coruna A Coruna Spain
| |
Collapse
|
6
|
Dubromel A, Caffin AG, Hacard F, Vantard N, Baudouin A, Herledan C, Larbre V, Schwiertz V, Nosbaum A, Pralong P, Nicolas JF, Berard F, Rioufol C, Ranchon F. Preparations of exploration of immediate hypersensitivity to antineoplastic agents: An oncology pharmacy perspective. J Oncol Pharm Pract 2021; 28:1552-1559. [PMID: 34546819 DOI: 10.1177/10781552211035695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cancer patients are being exposed to antineoplastic drugs more frequently and for longer periods, resulting in a higher risk of hypersensitivity reactions. The aim of this study was to assess the pharmaceutical time and direct cost of drug allergy explorations following immediate hypersensitivity reactions to antineoplastic agents. METHODS A micro-costing method was used to collect data on consumption of human and material resources for allergy exploration preparations. The monetisation was carried out on the basis of prices and hourly wage costs applied in 2018. The number and type of allergy explorations prepared by the pharmacy as well as nature of antineoplastic drugs tested, and the number of culprit drugs reintroductions were collected. RESULTS Almost 1.5 h is required to realise allergy tests for one patient including pharmacist time for prescription analysis and pharmacy technician's time for tests preparation. The mean manufacturing cost of these tests is estimated at €62.87 (€57.82-65.49) per culprit drug for one patient. Programming patients according to culprit drugs tested allows rationalising healthcare provider time and increasing efficiency. From January 2010 to December 2018, 277 patients were tested and 490 allergy explorations were performed, corresponding to more than 5000 preparations. Mostly, the culprit drug could be reintroduced (n = 383, 78.2%) allowing patients to receive the best possible treatment. CONCLUSION Management of hypersensitivity reactions is constantly progressing, as it contributes to improving patient care in oncology. This activity is time-consuming for the pharmacy team but allows patients with previous hypersensitivity reaction to continue effective treatment.
Collapse
Affiliation(s)
- Amélie Dubromel
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France
| | - Anne-Gaëlle Caffin
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France
| | - Florence Hacard
- Groupement Hospitalier Sud, Allergy and Clinical Immunology Department, 26900Hospices Civils de Lyon, France
| | - Nicolas Vantard
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France
| | - Amandine Baudouin
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France
| | - Chloé Herledan
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France.,27098Université Lyon 1, EA 3738, Centre d'Innovation en Cancérologie de Lyon, France
| | - Virginie Larbre
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France.,27098Université Lyon 1, EA 3738, Centre d'Innovation en Cancérologie de Lyon, France
| | - Vérane Schwiertz
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France
| | - Audrey Nosbaum
- Groupement Hospitalier Sud, Allergy and Clinical Immunology Department, 26900Hospices Civils de Lyon, France
| | - Pauline Pralong
- Groupement Hospitalier Sud, Allergy and Clinical Immunology Department, 26900Hospices Civils de Lyon, France
| | - Jean-François Nicolas
- Groupement Hospitalier Sud, Allergy and Clinical Immunology Department, 26900Hospices Civils de Lyon, France.,Université Lyon 1, Inserm, U111 CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Frédéric Berard
- Groupement Hospitalier Sud, Allergy and Clinical Immunology Department, 26900Hospices Civils de Lyon, France.,Université Lyon 1, Inserm, U111 CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Catherine Rioufol
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France.,27098Université Lyon 1, EA 3738, Centre d'Innovation en Cancérologie de Lyon, France
| | - Florence Ranchon
- Groupement Hospitalier Sud, Clinical Oncology Pharmacy Department, 26900Hospices Civils de Lyon, France.,27098Université Lyon 1, EA 3738, Centre d'Innovation en Cancérologie de Lyon, France
| |
Collapse
|
7
|
Huang YM, Ling H, Chen CB, Wang CH. Identification of docetaxel, cisplatin, and 5-fluorouracil regimen hypersensitivity by In vitro T-cell activation assay. JOURNAL OF CANCER RESEARCH AND PRACTICE 2019. [DOI: 10.4103/jcrp.jcrp_11_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
8
|
Huq M, Balvanz TM, Mambourg S. Docetaxel-induced cardiac-respiratory arrest in a patient with chronic atrial fibrillation. J Oncol Pharm Pract 2018; 24:531-536. [DOI: 10.1177/1078155217714860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Docetaxel has been approved by the Food and Drug Administration for the treatment of many cancer types, including breast cancer, head and neck cancer, lung cancer, and prostate cancer. Many severe to life-threatening side effects (Grades 3–5) of docetaxel have been reported in clinical trials, case reports, and Food and Drug Administration Adverse Events Reporting System. These include anaphylactic reactions, febrile neutropenia, fluid retention, acute respiratory distress, pleural effusion, pneumonia, and peripheral neuropathy. There were fewer cardiac toxicities reported for docetaxel as compared to paclitaxel, which were less severe. In this report, we present a clinical case of docetaxel-induced cardiac-respiratory arrest in a 62-year-old Hispanic male patient with stable chronic atrial fibrillation, who has been recently diagnosed with metastatic prostate cancer. The cardiac event developed within 15 min of docetaxel infusion during the second cycle of chemotherapy despite using recommended premedication with corticosteroids.
Collapse
Affiliation(s)
- Mostaqul Huq
- Pharmacy Services, VA Sierra Nevada Health Care System, US Department of Veterans Affairs, Reno, NV, USA
| | - Tracie M Balvanz
- Pharmacy Services, VA Sierra Nevada Health Care System, US Department of Veterans Affairs, Reno, NV, USA
| | - Scott Mambourg
- Pharmacy Services, VA Sierra Nevada Health Care System, US Department of Veterans Affairs, Reno, NV, USA
| |
Collapse
|
9
|
Wu HL. Retrospective evaluation of a rechallenge protocol in patients experiencing hypersensitivity reactions with prior chemotherapy in a tertiary hospital. J Oncol Pharm Pract 2018; 25:1388-1395. [PMID: 30176784 DOI: 10.1177/1078155218796190] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
When encountering a hypersensitivity reaction to chemotherapy, a dilemma arises whether to continue the current regimen. In our institution, a standardized protocol has been developed. This study evaluated the effectiveness and safety of our rechallenge protocol in rechallenging patients with previous hypersensitivity reactions of grades 1 to 2 to paclitaxel, docetaxel, carboplatin and oxaliplatin. The protocol consisted of intensification of premedication and lengthening of infusion time. A retrospective review of electronic medical records was conducted. Patients who attempted rechallenge with paclitaxel, docetaxel, carboplatin and oxaliplatin under the protocol during the time period from August 2014 to December 2015 were included. Forty-six rechallenge cases were included (12 paclitaxel, 15 docetaxel, 5 carboplatin and 15 oxaliplatin cases). The first rechallenge cycle was completed successfully in 43/46 patients (93.5%) and 42/46 patients (91.3%) were hypersensitivity reaction-free throughout the treatment course under the rechallenge protocol. A total of 133/137 cycles (97.1%) were completed successfully under the protocol. Among patients who continued chemotherapy until disease progression or treatment completion, a median of three additional cycles (range: 1 to 9 cycles) were administered under the protocol. The four cases of recurrent hypersensitivity reactions responded well to infusion interruption and symptomatic treatment and all four patients were discharged uneventfully. Further rechallenge was not performed. Our study demonstrated that a combined strategy of intensification of premedication and lengthening of infusion duration is effective and probably safe in rechallenging patients with previous grades 1 to 2 hypersensitivity reaction to paclitaxel, docetaxel, carboplatin and oxaliplatin.
Collapse
Affiliation(s)
- Hiu-Lok Wu
- Department of Pharmacy, Tuen Mun Hospital, Tuen Mun, Hong Kong
| |
Collapse
|
10
|
Jimenez-Rodriguez TW, Garcia-Neuer M, Alenazy LA, Castells M. Anaphylaxis in the 21st century: phenotypes, endotypes, and biomarkers. J Asthma Allergy 2018; 11:121-142. [PMID: 29950872 PMCID: PMC6016596 DOI: 10.2147/jaa.s159411] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Anaphylaxis is the most serious of all allergic reactions and can be fatal. The diagnosis is frequently delayed, and misdiagnosis often occurs with asthma or urticaria. Biomarkers such as tryptase are not routinely checked, and appropriate treatment with epinephrine is not administered in a majority of cases, increasing the risk of poor outcomes. The objective of this review is to provide a better understanding of the pathophysiology of anaphylaxis with a description of phenotypes, endotypes, and biomarkers available in both the clinical and research settings. Expanding knowledge with regard to the presentation, causes, and triggers for anaphylaxis among health care providers will improve its diagnosis and management, increase patient safety, and decrease morbidity and mortality.
Collapse
Affiliation(s)
- Teodorikez Wilfox Jimenez-Rodriguez
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Allergy Section, Alicante General University Hospital, Alicante, Spain
- PhD Program in Public Health, Medical and Surgical Sciences, Miguel Hernandez University, Alicante, Spain
| | - Marlene Garcia-Neuer
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Leila A Alenazy
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mariana Castells
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
11
|
Options in Hypersensitivity Reactions to Chemotherapeutics. CURRENT TREATMENT OPTIONS IN ALLERGY 2018. [DOI: 10.1007/s40521-018-0160-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
12
|
|
13
|
Sauvage F, Messaoudi S, Fattal E, Barratt G, Vergnaud-Gauduchon J. Heat shock proteins and cancer: How can nanomedicine be harnessed? J Control Release 2017; 248:133-143. [PMID: 28088573 DOI: 10.1016/j.jconrel.2017.01.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 01/08/2017] [Indexed: 12/18/2022]
Abstract
Heat shock protein (hsp90) is an interesting target for cancer therapy because it is involved in the folding and stabilization of numerous proteins, including many that contribute to the development of cancer. It is part of the chaperone machinery that includes other heat shock proteins (hsp70, hsp27, hsp40) and is mainly localized in the cytosol, although many analogues or isoforms can be found in mitochondrion, endoplasmic reticulum and the cell membrane. Many potential inhibitors of hsp90 have been tested for cancer therapy but their usefulness is limited by their poor solubility in water and their ability to reach the target cells and the correct intracellular compartment. Nanomedicine, the incorporation of active molecules into an appropriate delivery system, could provide a solution to these drawbacks. In this review, we explain the rationale for using nanomedicine for this sort of cancer therapy, considering the properties of the chaperone machinery and of the different hsp90 analogues. We present some results that have already been obtained and put forward some strategies for delivery of hsp90 analogues to specific organelles.
Collapse
Affiliation(s)
- Félix Sauvage
- Institut Galien Paris-Sud, CNRS, UMR 8612, LabEx LERMIT, Univ. Paris-Sud/Univ. Paris-Saclay, 5 rue J.-B. Clément, Châtenay-Malabry, 92296, France
| | - Samir Messaoudi
- BioCIS-UMR 8076, Univ. Paris-Sud, CNRS, University Paris-Saclay, Châtenay-Malabry, 92296, France
| | - Elias Fattal
- Institut Galien Paris-Sud, CNRS, UMR 8612, LabEx LERMIT, Univ. Paris-Sud/Univ. Paris-Saclay, 5 rue J.-B. Clément, Châtenay-Malabry, 92296, France
| | - Gillian Barratt
- Institut Galien Paris-Sud, CNRS, UMR 8612, LabEx LERMIT, Univ. Paris-Sud/Univ. Paris-Saclay, 5 rue J.-B. Clément, Châtenay-Malabry, 92296, France
| | - Juliette Vergnaud-Gauduchon
- Institut Galien Paris-Sud, CNRS, UMR 8612, LabEx LERMIT, Univ. Paris-Sud/Univ. Paris-Saclay, 5 rue J.-B. Clément, Châtenay-Malabry, 92296, France.
| |
Collapse
|
14
|
Bano N, Najam R, Qazi F, Mateen A. Clinical Features of Oxaliplatin Induced Hypersensitivity Reactions and Therapeutic Approaches. Asian Pac J Cancer Prev 2016; 17:1637-41. [DOI: 10.7314/apjcp.2016.17.4.1637] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|