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Related Experiment Videos

Carboplatin desensitization.

James Choi1, Paul Harnett, David A Fulcher

  • 1Immunology Unit, Westmead Hospital, Westmead, Sydney, Australia.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|August 27, 2004
PubMed
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Short carboplatin desensitization protocols fail in patients with hypersensitivity reactions. Longer, multi-day desensitization regimens are safe and effective for carboplatin chemotherapy.

Area of Science:

  • Oncology
  • Clinical Pharmacology
  • Allergy and Immunology

Background:

  • IgE-mediated hypersensitivity reactions to carboplatin occur in up to 30% of patients, limiting treatment options.
  • Severe anaphylactic reactions necessitate alternative chemotherapy strategies or desensitization protocols.

Purpose of the Study:

  • To evaluate the efficacy and safety of intravenous carboplatin desensitization regimens.
  • To develop a standardized protocol for safe carboplatin administration in hypersensitive patients.

Main Methods:

  • Eight ovarian cancer patients with prior severe carboplatin reactions underwent intradermal skin testing.
  • Patients were initially treated with short desensitization protocols (90 minutes to 6 hours), followed by a longer, gradual dose escalation protocol over 4 days.

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Main Results:

  • Short desensitization protocols failed in 3 of 3 patients.
  • A longer, 4-day desensitization protocol was tolerated by all 8 patients without allergic reactions.
  • Tumor marker response was observed in all but one patient receiving the longer protocol.

Conclusions:

  • Short carboplatin desensitization protocols (<6 hours) have a high failure rate.
  • Longer, multi-day carboplatin desensitization protocols are well-tolerated and effective in preventing allergic reactions.
  • Clinicians should consider longer desensitization regimens for patients requiring carboplatin chemotherapy despite a history of anaphylaxis.