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Effective desensitization protocol to paclitaxel following hypersensitivity reaction.
A. Fishman1, T. Gold, A. Goldberg
1Gynecologic Oncology Unit, Department of Obstetrics & Gynecology, Holon, Tel Aviv University Medical School, Kfar-Saba, Israel; Clinical Allergy and Immunology Unit, Meir Hospital - Sapir Medical Center, Holon, Tel Aviv University Medical School, Kfar-Saba, Israel; Wolfson Medical Center, Holon, Tel Aviv University Medical School, Kfar-Saba, Israel.
Summary
This study shows that a paclitaxel desensitization protocol is safe and effective for ovarian cancer patients who experienced severe hypersensitivity reactions. This method allows continued paclitaxel chemotherapy without interruption.
Area of Science:
- Oncology
- Pharmacology
- Immunology
Background:
- Severe hypersensitivity reactions (HSRs) to paclitaxel can necessitate treatment interruption.
- Ovarian cancer patients receiving paclitaxel chemotherapy are at risk for HSRs.
Purpose of the Study:
- To describe the experience with a desensitization protocol for paclitaxel in patients with a history of severe hypersensitivity reactions.
- To evaluate the feasibility, safety, and efficacy of this desensitization protocol.
Main Methods:
- Retrospective review of 75 ovarian cancer patients who received paclitaxel-based chemotherapy.
- Implementation of a desensitization protocol involving serial 10-fold dilutions of paclitaxel.
- Intravenous administration of escalating doses of diluted paclitaxel, followed by the undiluted drug, with continuous vital sign monitoring.
Main Results:
- Six patients with prior paclitaxel-associated HSRs were successfully treated using the desensitization protocol.
- The protocol was feasible and safe, with no reported compromise in cytotoxic activity.
- This strategy allowed for the continuation of paclitaxel-based chemotherapy.
Conclusions:
- Paclitaxel desensitization is a viable and safe option for patients with severe hypersensitivity reactions.
- This protocol can prevent the interruption of essential paclitaxel-based cancer treatment regimens.
- The desensitization strategy offers a reasonable clinical approach in managing paclitaxel hypersensitivity.