Maintaining oxaliplatin therapy after hypersensitivity reactions: real-world experience with a desensitisation...

Area of Science:

• Oncology
• Clinical Pharmacology

Background:

• Hypersensitivity reactions (HSRs) to oxaliplatin affect 7-25% of patients, posing a challenge for continued treatment.
• Drug desensitisation protocols (DDPs) are used despite limited evidence, offering a potential solution for patients benefiting from oxaliplatin.

Purpose of the Study:

• To evaluate the feasibility and outcomes of oxaliplatin desensitisation at a tertiary cancer centre.
• To assess HSR recurrence rates and treatment completion in patients undergoing oxaliplatin desensitisation.

Main Methods:

• Retrospective observational study of 66 patients with gastrointestinal malignancies receiving oxaliplatin chemotherapy with a DDP.
• Analysis of clinicopathological characteristics, oncological outcomes, HSR recurrence, and treatment completion.

Main Results:

• Most patients (53% colorectal, 39% upper GI) received oxaliplatin desensitisation, primarily with palliative intent (85%).
• 83% of patients successfully completed intended treatment, with 76% continuing original therapy without modification.
• 16% experienced recurrent HSRs, but overall oncological outcomes were acceptable, including treatment response and disease stabilization.

Conclusions:

• Oxaliplatin desensitisation is a feasible strategy for managing HSRs in eligible patients.
• This protocol allows continued access to effective chemotherapy, maintaining acceptable oncological outcomes and low discontinuation rates.