Allergy evaluation in hypersensitivity to platinum compounds and taxanes: a 5-year experience

Background. Platinum compounds (PC) and taxanes (TX) are drugs frequently administered for the treatment of several cancers. In recent years, their increased use has been accompanied by a relatively high prevalence of hypersensitivity reactions (HSRs). In this study, we report our comprehensive experience of allergy skin test (ST) evaluation in 276 patients who experienced HSRs to PC and/or TX. Primary objectives were to determine the clinical characteristics of HSRs, and to assess the role of STs in the diagnosis and prevention of HSRs in order to address the subsequent treatments. Secondary objective was to evaluate any cross-reactivity between PC (cisplatin, oxaliplatin and carboplatin) and among TX (paclitaxel and docetaxel). Methods. A monocentric, retrospective, observational, cohort study including patients who experienced one or more HSR during PC and/or TX chemotherapy was conducted from May 2018 to July 2023 in the Allergy and Clinical Immunology Unit at the "Fondazione Policlinico Universitario A. Gemelli" IRCCS, Rome. Results. A total of 114 patients with positive ST were identified: 102 for PC, 11 for TX and one for both. 162 patients were tested negative. Patients with HSR to PC were found to be allergic in 64%, compared to 9,9% of patients with HSR to TX (p < 0.0001). Patients who experience more serious reactions have a higher chance to have a positive result on STs (p < .01). Conclusions. STs to investigate sensitization to TX or PC is a highly valuable diagnostic tool in selecting the appropriate therapy when a hypersensitivity reaction occurs.