Adverse Reactions to Taxanes in Premedicated Cancer Patients: A Prospective Observational Study

Area of Science:

• Oncology
• Pharmacology
• Clinical Medicine

Background:

• Taxanes (paclitaxel, docetaxel, cabazitaxel) are vital chemotherapy agents targeting microtubules but cause significant adverse reactions, including infusion-related reactions (IRRs).
• Standard premedication protocols often fail to fully mitigate taxane-induced side effects, potentially leading to treatment delays or cessation.
• Understanding the incidence and spectrum of these reactions is crucial for optimizing patient care and treatment success.

Purpose of the Study:

• To determine the frequency of adverse reactions to taxanes in cancer patients receiving premedication.
• To assess the causality, severity, and nature of observed taxane-related adverse events.
• To inform improved management strategies for taxane chemotherapy.

Main Methods:

• A prospective observational study was conducted over six months, monitoring patients receiving taxane chemotherapy.
• Adverse reactions were recorded and graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
• Causality of reactions was assessed using the World Health Organization-Uppsala Monitoring Center (WHO-UMC) system.

Main Results:

• A total of 236 adverse reactions were documented across 206 treatment cycles in 56 patients, with 9 instances of infusion-related reactions (IRRs).
• Common non-IRRs included alopecia, numbness, myalgia, and mucositis; common IRRs were flushing, chest tightness, and dyspnea, mostly of grade 2 or less.
• The majority of adverse events were classified as probable/possible reactions according to the WHO-UMC scale.

Conclusions:

• Infusion-related reactions (IRRs) represent a small fraction (3.8%) of taxane-related adverse events in premedicated cancer patients.
• Neither IRRs nor other adverse reactions necessitated treatment discontinuation in this cohort.
• Implementing desensitization protocols and the Paclitaxel-Hypersensitivity Reaction (Pac-HSR) scoring system may further enhance the management of IRRs/HSRs, ensuring treatment continuity and safety.