Oxaliplatin-associated hypersensitivity reactions: clinical presentation and management

Hypersensitivity reactions to cisplatin and carboplatin have been reported in the literature to occur at a rate of 10%-27%. Initial reports of hypersensitivity reactions to oxaliplatin were low; however, more recently, it appears as if the incidence of hypersensitivity reactions to oxaliplatin is similar to that of the earlier generation platinum agents. The degree of the reaction varies from mild flushing to life-threatening anaphylactic responses. After a mild hypersensitivity reaction to oxaliplatin, re-exposing a patient can be considered after administering immunosuppressants (eg, high-dose corticosteroids and histamine antagonists) and/or prolonging the duration of oxaliplatin infusion. In the case of moderate-to-severe reactions to oxaliplatin, re-exposure is usually not considered, and alternative forms of therapy should be explored. However, there are reports of successful desensitization to oxaliplatin, and therefore, re-exposing a patient can be considered after carefully weighing the risks and benefits of additional oxaliplatin therapy.