Rechallenges without desensitization following platinum-based chemotherapy reactions

Area of Science:

• Oncology
• Clinical Pharmacology
• Allergy and Immunology

Background:

• Growing interest in non-desensitization protocols for chemotherapy reintroduction post-hypersensitivity reactions (HSR).
• Need for safe reintroduction strategies, particularly where allergy consultation is limited.

Purpose of the Study:

• To evaluate the safety and efficacy of non-desensitization reintroduction protocols for chemotherapy in patients with platinum hypersensitivity.
• To assess the utility of extended and titrated infusion methods compared to standard infusions.

Main Methods:

• Retrospective review of 70 patients with platinum HSR undergoing rechallenge with standard, extended, or titrated infusions.
• Analysis of initial and breakthrough reactions (BTR) using CTCAE v5.0 criteria.
• Comparison of tolerance and completion rates between different infusion protocols.

Main Results:

• Extended infusions showed significantly higher tolerance (87% vs 8%) and completion (96% vs 38%) compared to standard infusions.
• Titrated infusions also demonstrated improved tolerance (76% vs 8%) and completion (79% vs 38%) over standard infusions.
• No significant difference in outcomes between extended and titrated infusions was noted.

Conclusions:

• Extended and titrated infusion protocols enhance the safety of chemotherapy reintroduction following HSR.
• These non-desensitization methods present a practical alternative for institutions lacking desensitization resources.
• Further research into extended infusions could establish them as a safe standard for HSR management.