Document Detail

Successful rechallenge for oxaliplatin hypersensitivity reactions in patients with metastatic colorectal cancer.
MedLine Citation:
PMID:  23225461     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Discontinuation of oxaliplatin-containing regimens is sometimes necessary due to hypersensitivity reactions for which effective countermeasures have not yet been identified.
PATIENTS AND METHODS: We retrospectively reviewed cases in which hypersensitivity reactions developed in 623 patients treated with oxaliplatin for colorectal cancer. Clinical outcomes of patients who underwent oxaliplatin rechallenge with rechallenge protocol (STEP 1: hydrocortisone, chlorpheniramine, and/or ranitidine; STEP 2: hydrocortisone with an escalating dose to 500 mg, and/or prolonged administration time of oxaliplatin; and STEP 3: STEP 2 plus a subcutaneous injection of epinephrine) were examined.
RESULTS: Out of 623 patients, 126 (20.2%) patients developed hypersensitivity reactions. Out of these 126 patients, 99 (78.6%) underwent oxaliplatin rechallenge. As the initial oxaliplatin rechallenge, 19 patients received subsequent treatment without the rechallenge protocol and 80 patients received oxaliplatin with the rechallenge protocol of STEP 1 (n=64), STEP 2 (n=15), and STEP 3 (n=1). The median number of oxaliplatin rechallenges was 3 (range=1 to 29). The reason for treatment discontinuation was disease progression in 55 patients (56%) and hypersensitivity reactions in 21 patients (21%). Overall hypersensitivity reactions after rechallenge were observed in 59%, with grade 3/4 in 6%.
CONCLUSION: The rechallenge protocol is an effective treatment option for patients with oxaliplatin hypersensitivity reactions.
Takako Yanai; Satoru Iwasa; Hirhonobu Hashimoto; Ken Kato; Tetsuya Hamaguchi; Yasuhide Yamada; Yasuhiro Shimada; Hiroshi Yamamoto
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anticancer research     Volume:  32     ISSN:  1791-7530     ISO Abbreviation:  Anticancer Res.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8102988     Medline TA:  Anticancer Res     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  5521-6     Citation Subset:  IM    
Division of Pharmacy, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
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