A new non-dilution rapid desensitization protocol successfully applied to all-grade platinum hypersensitivity

Area of Science:

• Oncology
• Clinical Pharmacy
• Immunology

Background:

• Hypersensitivity reactions (HSRs) to platinum-based chemotherapy necessitate alternative administration protocols.
• Traditional desensitization involves multiple serial dilutions, which is labor-intensive and complex.
• A simplified, non-dilution protocol is needed for broader clinical application.

Purpose of the Study:

• To assess the safety and efficacy of a novel non-dilution, one-bag desensitization protocol for platinum chemotherapy in patients with HSRs.
• To evaluate the outcomes and safety profile of this new protocol compared to existing methods.

Main Methods:

• An observational study was conducted on 36 patients with platinum HSRs (23 oxaliplatin, 9 carboplatin, 4 cisplatin).
• Patients underwent a new non-dilution, one-bag desensitization protocol with premedication (Montelukast, H1/H2 blockers).
• Outcomes, including breakthrough reactions (BTRs) and reaction severity, were assessed.

Main Results:

• All 175 desensitization procedures were successfully completed, enabling re-administration of platinum agents.
• 83.4% of procedures had no BTRs; 16.6% experienced BTRs, mostly mild or moderate.
• Severe HSRs occurred in only 3.5% of procedures, significantly lower than initial HSR rates (25%).

Conclusions:

• The new non-dilution desensitization protocol is safe and effective for re-administering platinum agents in patients with HSRs.
• This simplified protocol serves as a practical alternative to existing multi-dilution methods.
• It facilitates continued essential chemotherapy for patients with platinum hypersensitivity.