Use of Docetaxel After Paclitaxel Hypersensitivity Reaction in Epithelial Ovarian and Endometrial Cancer (original) (raw)
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Hypersensitivity Reactions to the Taxanes Paclitaxel and Docetaxel
Clinical Drug Investigation, 1997
Paclitaxel and docetaxel are taxane derivatives with a significant antitumour activity. For both drugs, a high incidence of hypersensitivity reactions (HSRs) has been observed during the initial clinical development. However, current pretreatment regimens, consisting of corticosteroids and antihistamines, have led to a substantial decrease in major HSRs. In this study, we describe a case series of 9 out of a total of 415 patients from eight different taxane studies who received either paclitaxel or docetaxel and experienced severe HSRs, despite the use of premedication. Five of these 9 patients had allergies or atopy. We observed an increase in blood pressure during the HSR in 5 patients, whereas a decrease was anticipated. Retreatments, with additional corticosteroids, antihistamines and in some cases a lower infusion rate, were performed successfully in 7 patients. One of these patients was given, after two courses with HSR symptoms, sodium cromoglycate as prophylaxis, after which she received four successive courses without symptoms of HSR.
Journal of gynecologic oncology, 2017
To report on the incidence of nab-paclitaxel hypersensitivity reactions (HSRs) in patients with prior taxane HSR. From 2005 to 2015, all patients who received nab-paclitaxel for a gynecologic malignancy were identified. Chart abstraction included pathology, prior therapy, indication for nab-paclitaxel, dosing, response, toxicities including any HSR, and reason for discontinuation of nab-paclitaxel therapy. We identified 37 patients with gynecologic malignancies with a history of paclitaxel HSR who received nab-paclitaxel. Six patients (16.2%) had a prior HSR to both paclitaxel and docetaxel while the other 31 patients had not received docetaxel. No patients experienced a HSR to nab-paclitaxel. Median number of cycles of nab-paclitaxel was 6 (range 2-20). Twelve patients received weekly dosing at 60 to 100 mg/m². The remainder of patients received 135 mg/m² (n=13), 175 mg/m² (n=9), or 225 mg/m² (n=3). Thirty four patients (91.9%) received nab-paclitaxel in combination with carboplati...
Gynecologic Oncology, 2005
Purpose of review Hypersensitivity reactions (HSRs) to chemotherapy agents have limited their use for fear of inducing severe reactions or death. Alternative regimens may be limited by tumor sensitivity and the need to provide first-line therapy. Rapid desensitizations allow patients to be treated with medications to which they have presented a HSR. The purpose of this review is to highlight the indications and recent developments in chemotherapy rapid desensitization protocols. Recent findings Intravenous and oral rapid desensitization protocols are available for taxenes, platinums, doxorubicin, monoclonal antibodies and others. Candidate patients present mild to severe type I hypersensitivity, mast cell/IgE-dependent reactions, as seen with platinums. Anaphylactoid reactions, such as those with taxenes, can be treated with the same protocols. Repeat desensitizations in outpatient settings are well tolerated and allow patients to remain in clinical studies/trials. Breakthrough symptoms during desensitizations are less severe than the initial reaction and no deaths have been reported. Cancer remissions are similar to those for nondesensitized patients. Summary The use of rapid desensitization protocols for cancer patients with HSRs to chemotherapy depends on their demonstrated tolerability and efficacy in selected populations. Education of nurses, pharmacists, and oncology and allergy specialists is needed to improve their universal application as standard of care.
Cross-sensitivity between paclitaxel and docetaxel in a women's cancers program
Gynecologic Oncology, 2006
Purpose. With the use of steroid premedication, the incidence of severe hypersensitivity reactions (S-HSR) to paclitaxel is estimated to be 2%. For those who develop a S-HSR to paclitaxel, docetaxel has been employed as an alternative agent though the presence of cross-sensitivity has not been established. We sought to define the incidence of S-HSR to docetaxel following a paclitaxel S-HSR in an academic women's cancer program.
Supportive Care in Cancer, 2011
Purpose Paclitaxel-based chemotherapy continues to be an integral component in the treatment of many solid tumors. Prolonged use of paclitaxel may result in repeated doses of premedications and potential unwanted side effects. Infusion hypersensitivity reactions occurring beyond the second dose are infrequent and not well characterized. We hypothesized that patients whose paclitaxel premedications were discontinued after two doses were unlikely to experience infusion hypersensitivity reactions with subsequent paclitaxel doses. Methods Patients receiving paclitaxel-based chemotherapy who did not experience an infusion hypersensitivity reaction with their first or second dose had their paclitaxel premedications discontinued. The primary endpoint was to estimate the incidence of rescue medication for the treatment of paclitaxel infusion hypersensitivity during doses 3 to 6 for patients whose paclitaxel premedications had been discontinued. Results After receiving the first two doses of paclitaxelbased chemotherapy without experiencing an infusion hypersensitivity reaction (any grade), 55 breast cancer patients had their premedications discontinued for all remaining paclitaxel doses. None of these patients required rescue medication to treat an infusion hypersensitivity reaction with subsequent doses. Conclusions In patients who have not experienced an infusion hypersensitivity reaction with the first two doses of paclitaxel, discontinuation of paclitaxel premedications may be considered an option without an increased risk of infusion hypersensitivity requiring rescue medication.
Hypersensitivity reaction (HSR) to docetaxel after previous HSR to paclitaxel
Journal of Clinical Oncology
Chakrabarti interprets the failure to observe a survival benefit of GVHD after DLI in our study to mean that a GVL effect was not operative. This is not necessarily true. Horowitz et al 5 showed that the GVL effect need not occur in the context of clinically evident GVHD. However, in the absence of a randomized comparison, we make no claim of superiority of our approach over any other. For example, Pawson et al 6 recently reported overall survival of 60% and diseasefree survival of 28% at 58 months after a second nonmyeloablative transplant for acute leukemia relapse following a failed first allogeneic transplant. We believe that further investigation into inducing meaningful GVL effects while minimizing regimen-related and GVHDrelated mortality is warranted for patients with advanced myeloid leukemia relapse after allogeneic stem-cell transplantation.
Hypersensitivity reaction (HSR) to docetaxel after a previous HSR to paclitaxel
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2002
Chakrabarti interprets the failure to observe a survival benefit of GVHD after DLI in our study to mean that a GVL effect was not operative. This is not necessarily true. Horowitz et al 5 showed that the GVL effect need not occur in the context of clinically evident GVHD. However, in the absence of a randomized comparison, we make no claim of superiority of our approach over any other. For example, Pawson et al 6 recently reported overall survival of 60% and diseasefree survival of 28% at 58 months after a second nonmyeloablative transplant for acute leukemia relapse following a failed first allogeneic transplant. We believe that further investigation into inducing meaningful GVL effects while minimizing regimen-related and GVHDrelated mortality is warranted for patients with advanced myeloid leukemia relapse after allogeneic stem-cell transplantation.
Asian Biomedicine
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 coll...