Hypersensitivity reactions to chemotherapy drugs are frequent. Desensitization for chemotherapy drugs has become an option to maintain first-line therapy in patients who have suffered such reactions.
This study from Spain described desensitization with antineoplastic agents using a rapid 1-solution protocol.
Skin test was performed at concentrations previously described as nonirritant.
Desensitization was performed using only 1 solution of the drug prepared following the manufacturer instructions. Most drugs were diluted in a volume of 500 mL. The study authors started infusion at 5 mL/h and increased doses at 15-minute intervals to 10, 25, 50, 75, and 100 mL/h. If no reaction occurred, and if the pharmacokinetics of the drug allowed it, they stepped up to 150, 200, and 250 mL/h.
90 patients were desensitized to 93 drugs: oxaliplatin (30), carboplatin (16), paclitaxel (19), docetaxel (6), cetuximab (5), rituximab (6), and others (11).
A total number of 490 procedures were performed. Sixteen patients (17.77%) presented 26 reactions (5.3%). Most reactions appeared in patients who were desensitized to platins and in patients with severe reactions. All but 3 cycles were completely administrated.
This 1-solution protocol for desensitization was demonstrated to be safe and useful in our study population, especially for mild-to-moderate reactions and nonplatinum drugs.
References:
Outcome of 490 Desensitizations to Chemotherapy Drugs with a Rapid One-Solution Protocol http://bit.ly/2DSFlHA
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