Immediate hypersensitivity reactions to antineoplastic agents - A practical guide for the oncologist
Sofie Seghers1, Laure-Anne Teuwen2, Michiel Beyens3
1Department of oncology, Antwerp University Hospital, Antwerp, Belgium; Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium.
Cancer Treatment Reviews
|April 21, 2023
Summary
Immediate hypersensitivity reactions (IHRs) to cancer treatments like chemotherapy and monoclonal antibodies are common. This review clarifies IHRs, offering guidance for oncologists on diagnosis and management to improve patient care.
Area of Science:
- Oncology
- Clinical Immunology
- Pharmacology
Background:
- Immediate hypersensitivity reactions (IHRs) to antineoplastic agents are frequent and can significantly disrupt cancer treatment.
- Lack of clear oncologic guidelines for IHR diagnosis and management poses a challenge for clinicians.
Purpose of the Study:
- To provide a comprehensive review of IHRs to antineoplastic agents, focusing on definition, pathophysiology, epidemiology, diagnosis, and management.
- To offer practical guidance for oncologists encountering IHRs in clinical practice.
Main Methods:
- Review of existing literature on IHRs to chemotherapeutic agents and monoclonal antibodies.
- Synthesis of information regarding mechanisms, clinical presentations, diagnostic work-up, and treatment strategies.
Main Results:
- IHRs encompass a spectrum of reactions, from mild to life-threatening, caused by various antineoplastic agents.
- Key culprits include platinum compounds, taxanes, and monoclonal antibodies (mAbs).
- Diagnostic work-up aims to identify the causative agent and potential safe alternatives.
Conclusions:
- Effective management of IHRs requires understanding their mechanisms and clinical manifestations.
- This review provides a framework for improved diagnosis and treatment of IHRs, ultimately enhancing cancer patient care.
Related Concept Videos
01:30Hypersensitivities
837
Hypersensitivity, also known as a hypersensitivity reaction or allergic reaction, is a condition where the body's immune system reacts abnormally to a foreign substance. Such substances, that cause hypersensitivity are referred to as an allergen, could be something typically harmless to most people, like pollen or certain foods.
Types of Hypersensitivities
Hypersensitivity reactions are categorized into four types: Type 1, Type 2, Type 3, and Type 4. Each type has a distinct mechanism...
Types of Hypersensitivities
Hypersensitivity reactions are categorized into four types: Type 1, Type 2, Type 3, and Type 4. Each type has a distinct mechanism...
837
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
215
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
215
01:27Allergic Drug Reactions
904
Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
904
01:29Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
367
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
367
02:06Allergic Reactions
28.0K
Overview
28.0K
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
263
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
263