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Hypersensitivity and idiosyncratic reactions to oxaliplatin
Rebecca R Thomas1, Mary G Quinn, Barbara Schuler
1Cancer Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, NCI-Navy Medical Oncology, National Naval Medical Center, Bethesda, Maryland 20889-5105, USA.
Cancer
|April 25, 2003
Summary
Hypersensitivity reactions to oxaliplatin can be managed in mild to moderate cases with premedication. Severe reactions may prevent further oxaliplatin therapy.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Oxaliplatin is a platinum-based chemotherapy agent used for solid tumors, notably colorectal cancer.
- Hypersensitivity reactions to oxaliplatin are infrequent but recognized complications.
Observation:
- Three patients in a Phase I trial experienced hypersensitivity reactions to oxaliplatin.
- Reactions varied from erythema and pruritus to fever and dyspnea.
- A literature review identified two reaction patterns: classic and idiosyncratic.
Findings:
- Successful rechallenge with oxaliplatin was achieved in all three patients using a premedication regimen.
- The regimen included oral dexamethasone, intravenous solumedrol, diphenhydramine, and cimetidine.
- Mild to moderate hypersensitivity cases responded to steroids and histamine receptor antagonists.
Implications:
- Premedication strategies can enable continued oxaliplatin treatment for patients with mild to moderate hypersensitivity.
- Severe hypersensitivity reactions may preclude further use of oxaliplatin.
- Understanding reaction patterns aids in managing chemotherapy-induced hypersensitivity.