Carboplatin hypersensitivity reactions: a single institution experience

Area of Science:

• Oncology
• Clinical Pharmacology

Background:

• Carboplatin hypersensitivity reactions (CHR) are common in heavily pretreated gynecologic cancer patients.
• These reactions can be severe, potentially lethal, and preclude effective salvage chemotherapy.
• Ovarian cancer is frequently associated with CHR.

Purpose of the Study:

• To describe the management of carboplatin hypersensitivity reactions.
• To evaluate a pretreatment protocol for safe carboplatin re-administration.
• To assess the efficacy of this protocol in patients with gynecologic malignancies.

Main Methods:

• A retrospective review of 20 patients who developed allergic reactions to carboplatin between 1998 and 2004.
• Implementation of a pretreatment protocol involving corticosteroids, antihistamines, and slow infusion rate.
• Comparison of outcomes between patients treated with and without the protocol.

Main Results:

• 13 of 20 patients were successfully re-treated with carboplatin after protocol implementation.
• 10 of these 13 patients experienced minor symptoms during subsequent courses.
• Only 1 of 6 patients re-treated without the protocol received further platinum-based treatment.

Conclusions:

• Pretreatment with corticosteroids, antihistamines, and a slower infusion rate enables safe carboplatin re-treatment.
• This protocol is effective in managing hypersensitivity reactions in gynecologic cancer patients.
• The described approach facilitates continued effective salvage therapy.