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Published on: November 9, 2016
Management and preparedness for infusion and hypersensitivity reactions.
1University of Southern California, Los Angeles, USA. lenz@usc.edu
The Oncologist
|May 25, 2007
Summary
Hypersensitivity reactions to cancer therapies like monoclonal antibodies and chemotherapy agents are manageable with proper monitoring and intervention. Understanding reaction onset is key for effective prevention and treatment strategies.
Area of Science:
- Oncology
- Pharmacology
- Immunology
Background:
- Systemic cancer therapies, including monoclonal antibodies, can cause hypersensitivity reactions.
- This review examines hypersensitivity reactions to monoclonal antibodies and common chemotherapy agents.
Purpose of the Study:
- To review the characteristics and management of hypersensitivity reactions to specific monoclonal antibodies and chemotherapy agents.
- To provide practical information for managing these adverse events.
Main Methods:
- Literature search of MEDLINE for recent studies and reviews on hypersensitivity reactions.
- Included monoclonal antibodies (cetuximab, rituximab, trastuzumab, panitumumab, bevacizumab), platinum compounds (carboplatin, oxaliplatin), and taxanes (paclitaxel, docetaxel).
- Supplemented literature data with information from agent package inserts.
Main Results:
- Severe hypersensitivity reactions are rare (< or =5%) with proper management.
- Platinum compound reactions are typically Type 1 hypersensitivity, occurring after multiple cycles.
- Taxane and monoclonal antibody reactions are usually immediate (first few minutes of first/second infusion), but 10%-30% can be delayed.
- Mild-to-moderate reactions managed by infusion interruption, rate reduction, and symptom management; rechallenge considered after resolution.
- Severe reactions may necessitate treatment discontinuation.
Conclusions:
- Hypersensitivity reactions to platinum compounds are acquired, while taxane and monoclonal antibody reactions are typically immediate.
- Different onset times necessitate tailored prevention and management strategies.
- Rechallenge or discontinuation decisions depend on reaction severity and clinical factors.
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