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Systemic therapy emergencies.

J Albanell1, J Baselga

  • 1Medical Oncology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Seminars in Oncology
|June 23, 2000
PubMed
Summary
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Chemotherapy can cause emergencies like drug extravasation and hypersensitivity reactions (HSRs). Management involves IV line care, temperature application, antidotes for extravasation, and premedication for HSRs.

Area of Science:

  • Oncology
  • Pharmacology
  • Emergency Medicine

Background:

  • Systemic cancer therapies, particularly chemotherapy, present unique emergency risks.
  • Drug extravasation and hypersensitivity reactions (HSRs) are two critical chemotherapy administration emergencies.
  • Biological agents are increasingly used in cancer therapy, necessitating an understanding of their distinct toxicity profiles.

Purpose of the Study:

  • To review unique emergencies associated with chemotherapy administration, specifically drug extravasation and hypersensitivity reactions (HSRs).
  • To discuss management strategies for chemotherapy-induced extravasation, including antidotes.
  • To outline approaches for managing and preventing HSRs and to introduce emergencies related to biological cancer agents.

Main Methods:

Related Experiment Videos

  • Literature review of chemotherapy and biological agent-induced emergencies.
  • Analysis of management protocols for drug extravasation, including specific antidotes.
  • Examination of hypersensitivity reaction (HSR) prevention and treatment strategies.
  • Review of toxicity profiles for biological agents like interferons, IL-2, fusion proteins, and monoclonal antibodies.

    • Main Results:

    • Drug extravasation management includes IV line maintenance, local cooling/warming, and specific antidotes (e.g., hyaluronidase, sodium thiosulfate, DMSO).
    • Hypersensitivity reactions (HSRs) are a concern with taxanes and L-asparaginase, requiring premedication; management may involve analog drugs or prophylaxis.
    • Emergencies associated with biological agents (interferons, IL-2, cytokine-toxin fusion proteins, rituximab, trastuzumab) have distinct toxicity profiles.

    Conclusions:

    • Effective management of chemotherapy-induced emergencies like extravasation and HSRs is crucial for patient safety.
    • Antidotes and premedication strategies play a vital role in mitigating chemotherapy administration risks.
    • Understanding the specific toxicities of emerging biological cancer therapies is essential for clinical practice.