on October 21, 2023
Overall, the evidence supports that the number of carboplatin cycles and dose are the principal risk factors for carboplatin-related hypersensitivity reactions, and that caution is warranted in cases of carboplatin infusion beyond 8 cycles or 3,500 mg. doi: 10.1016/j.ygyno.2016.09.027, Bruchim, I., Goldberg, A., Fishman, A., and Confino-Cohen, R. (2014). The yearly incidence of carboplatin-related hypersensitivity gradually increased from 0.88 in 2006 to 5.42% in 2013 (Table 1), in association with increased use of carboplatin. The imaging findings follow the American Thoracic Society and European Respiratory Society classification of interstitial pneumonia. Lacouture, V. Sibaud, P.A. 2017 Nov 8;8:1472. doi: 10.3389/fimmu.2017.01472. MBC: CLEOPATRA (NCT00567190; PMID 22149875, 23602601, 25693012; 32171426), MetaPHER (NCT02402712; 33748921); EBC: APHINITY (NCT01358877; 28581356, 33539215), NeoSphere (NCT00545688; 22153890, 27179402), TRYPHAENA (NCT00976989; 23704196, 29223479), BERENICE (NCT02132949; 29253081, SABCS 2017 P5-20-04), FeDeriCa (NCT03493854; 33357420), PHranceSCa (NCT03674112; ESMO 2020 165MO). The research protocol was reviewed and approved by the institutional review board of the hospital. All funding for this site is provided directly by ESMO. Women are more affected by drug allergy and up to 27% of women with ovarian and breast cancer develop carboplatin allergy after multiple cycles of treatment. Hypersensitivity & Infusion Reaction Management Author: Updated 2.21.19 Subject: SCC Pharmacy The drug or food allergy in 735 patients receiving carboplatin-based chemotherapy. 53, 121122. 24, 342351. (2011). Carboplatin hypersensitivity: does introduction of skin test and desensitization reliably predict and avoid the problem? Hypersensitivity reactions to carboplatin administration are common but not always severe: a 10-year experience. It would be worthwhile to design a perspective trial that could randomize patients with carboplatin hypersensitivity to receive an alternative regimen without carboplatin. -, A fatal anaphylactic reaction to paclitaxel is described, which was preceded by a possible delayed reaction to the initial infusion. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. Analysis and interpretation of data: Y-HT, Y-JT, H-CH, Y-YC, and W-FC. TABLE 3 Table 3. Adnan A, Acharya S, Alenazy LA, de Las Vecillas L, Giavina Bianchi P, Picard M, Calbache-Gil L, Romero-Pinedo S, Abad A-Molina AC, Kerr W, Pedicone C, Nagai J, Hollers E, Dwyer D, Castells M. J Immunol. Hypersensitivity reactions are generally unexpected, regulated by the immune system, and allergic in nature. Carboplatin is among the most commonly used chemotherapeutic agents for ovarian, fallopian tube, and primary peritoneal cancer, as it is active against these types of cancers with usually well-tolerated side effects (Ozols et al., 2003; Parmar et al., 2003; Pfisterer et al., 2006; Pujade-Lauraine et al., 2010). Supportive and Palliative Care | ESMO Management of Infusion Reactions to Systemic Anticancer Therapy: ESMO Clinical Practice Guidelines Published in 2017 - Ann Oncol (2017) 28 (suppl 4): iv100-iv118. The symptoms and signs of the 75 women with carboplatin-related hypersensitivity reactions are given in Table 4. The cumulative incidence of carboplatin-related hypersensitivity was 2% after 8 cycles, 6% after 14 cycles, 8% after 19 cycles, and 10% after 33 cycles, with a plateau beyond this cycle number (Figure 1A). Up to 16% of patients with ovarian cancer who undergo treatment with carboplatin-containing regimens experience carboplatin-related hypersensitivity (Markman et al., 1999; Polyzos et al., 2001; Sliesoraitis and Chikhale, 2005). MINIMAL Requirements:Google Chrome 24+,Mozilla Firefox 20+,Internet Explorer 11,Opera 1518,Apple Safari 7,SeaMonkey 2.15-2.23. Br. (1994). Such reactions could potentially be reduced or prevented by slowing the infusion rate and using a desensitization protocol involving anti-allergy medications. J. Clin. 20, 566573. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences. In our study, 36% of the patients with carboplatin-related hypersensitivity reactions had a history of drug allergies. Deleterious BRCA1/2 mutation is an independent risk factor for carboplatin hypersensitivity reactions. Cancer. (2010). Carboplatin hypersensitivity. 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'Allergy' is a hypersensitivity reaction (HSR) initiated by specic immunolo- gical mechanisms. 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We found a higher incidence of carboplatin-related hypersensitivity among patients with advanced disease (stage IIIIV) with serous carcinoma and malignant ascites. Among cases developing carboplatin-related hypersensitivity reactions, the median number of cycles is 912, and the median doses 6,0008,000 mg. Reported risk factors for carboplatin-related hypersensitivity reactions include carboplatin cycle/dose, platinum-free interval, and history of drug allergies (Libra et al., 2003; Confino-Cohen et al., 2005; Schwartz et al., 2007; Koshiba et al., 2009). ESMO 2017 Congress Integrating science into oncology for a better patient outcome Start date 08 Sep 2017 End date 12 Sep 2017 Location Madrid, Spain In an era of deep understanding of the molecular biology underlying the development of cancer, it is crucial that researchers and clinicians exchange knowledge. A. The scale uses a rational, structured and consistent approach to derive a relative ranking of the magnitude of clinically meaningful benefit that can be expected from anti-cancer treatments.ESMO-MCBS scores are included in ESMO Clinical Practice Guidelines to help further guide treatment decisions. 2017;40(3):120-127. doi: 10.1159/000458443. doi: 10.1093/annonc/mdx216. Zhonghua. Have a look to the ESMO 2017 Programme online! We retrospectively recruited all women with pathologically documented ovarian, fallopian tube, or primary peritoneal cancer treated with single-agent carboplatin or a carboplatin-based combination chemotherapy regimen at National Taiwan University Hospital from January 2006 to December 2013. and transmitted securely. PDF Management of Immune-related Adverse Events in Patients Treated - Asco The dilemma of carboplatin-associated hypersensitivity reactions in ovarian cancer management. Multivariate analysis was conducted using logistic regression to estimate the association between the potential risk factors and the occurrence of hypersensitivity. Table 4. doi: 10.1200/JCO.2006.06.0913, Polyzos, A., Tsavaris, N., Kosmas, C., Arnaouti, T., Kalahanis, N., Tsigris, C., et al. In 74 of the 75 patients, the hypersensitivity reactions subsided within several minutes to several hours after onset, and the patients recovered without any sequelae. Whether, BRCA 1/2 and HRD-related genes modulate Th2 gene expression and increase specific IgE to carboplatin is still unknown. Koshiba et al. 8600 Rockville Pike Drafting of manuscript: Y-HT and W-FC. The PAGA project aims to adapt the ESMO Clinical Practice Guidelines by integrating Asian ethnic, scientific, socioeconomic, and local practice characteristics. The ESMOClinical Practice Guidelines(CPGs) are intended to provide the user with a set of recommendations for the best standards of cancer care, based on the findings ofevidence-based medicine. Cisplatin administration following carboplatin desensitization failure in primary peritoneal cancer: a brief report. Rosell S, Blasco I, Garca Fabregat L, Cervantes A, Jordan K; ESMO Guidelines Committee. The ESMO Clinical Practice Guidelines, prepared and reviewed by leading experts and based on the findings of evidence-based medicine, provide you with a set of recommendations to help patients with the best care options. Epub 2012 May 3. -. Gynecol. By delivering the target dose of the drug by small incremental doubling doses (Figure 3), the threshold for anaphylaxis is re-established at each step and never reaches that of the initial triggering dose. There is evidence that inhibitory mechanisms blocking IgE/antigen mast cell activation are active during desensitization, enhancing safety. ESMO Virtual Congress 2020 | OncologyPRO For more detailed information on the cookies we use, please check our Privacy Policy. There is a need to further characterise risk of anaphylaxis/hypersensitivity with PH IV/PH FDC SC to support safe administration outside of clinics. Whether desensitization modulates drug allergic and anaphylactic responses facilitating tolerance is currently being investigated. doi: 10.1111/cas.12538, Kandel, M. J., Loehr, A., Harter, P., Traut, A., Gnauert, K., and du Bois, A. doi: 10.1016/S0140-6736(03)13718-X, Pfisterer, J., Plante, M., Vergote, I., du Bois, A., Hirte, H., Lacave, A. J., et al. This site needs JavaScript to work properly. Reducing the carboplatin infusion rate and employing desensitization protocols with anti-allergy medications are especially important for patients at high risk of carboplatin hypersensitivity to detect the hypersensitivity early and avoid severe hypersensitivity without compromising the efficacy of the antineoplastic regimen. Integrating science into oncology for a better patient outcome, ESMO Designated Centres Community Session, Create your own personalised agenda and browse the complete scientific programme by day, topic, cancer type and track with the. 4 - 9 Without premedication, hypersensitivity reactions (HSRs) occurred in 25%-30% of patients in these studies and clinical development of paclitaxel was consequently delayed. Check the latest publications and updates here to make sure you dont miss anything. HHS Vulnerability Disclosure, Help Bayer to Highlight New Research at ESMO 2017 Congress Gynecol. Would you like email updates of new search results? Genc et al. The incidence of carboplatin hypersensitivity ranges from 8 to 11% (Libra et al., 2003; Confino-Cohen et al., 2005; Schwartz et al., 2007; Koshiba et al., 2009). Our findings also suggest that a history of drug or food allergies is a predictive factor for carboplatin-related hypersensitivity. Oncol. Oncol Res Treat. Analysis included treatment cycle, causative drug, severity of reaction as per CTCAE v4 . Before Oncol. Disclaimer. ESMO Clinical Practice Guideline update on the use of systemic therapy (2003). 144, 7782. Cancer 109, 10721078. All of these reported symptoms and signs occurred within an hour of initiating carboplatin administration. Unable to load your collection due to an error, Unable to load your delegates due to an error. doi: 10.1111/j.1525-1438.2005.00136.x, Koshiba, H., Hosokawa, K., Kubo, A., Miyagi, Y., Oda, T., Miyagi, Y., et al. (2013). Libra, M., Sorio, R., Buonadonna, A., Berretta, M., Stefanovski, P., Toffoli, G., et al. Cancer 19, 12841287. This site uses cookies. The ESMO Congress is the most influential annual meeting for oncology professionals in Europe. ESMO on Anemia, Iron Deficiency in Cancer Patients Table 6. Drug Hypersensitivity and Anaphylaxis in Cancer and Chronic Inflammatory Diseases: The Role of Desensitizations Front Immunol. ESMO is a Swiss-registered not-for-profit organisation. 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Prior to an infusion of a mAb, nurses should do the following (Olsen et al., 2019): . (2006). ESMO Clinical Practice . 2014;24(2):72-9; quiz 2 p following 79. Za. Allergy in Cancer Care: Antineoplastic Therapy-Induced Hypersensitivity Reactions. Therefore, disease severity, histological type, malignant ascites, past drug allergies, and cumulative carboplatin dose are risk factors for carboplatin-related hypersensitivity reactions. (Bruchim et al., 2014) demonstrated safe re-treatment with carboplatin using a desensitization protocol to reduce repeated hypersensitivity reactions, and Koshiba et al. PDF Hypersensitivity & Infusion Reaction Management - Stephenson Cancer Center Pediatric. Paclitaxel plus platinum-based chemotherapy vs. conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. 2022 Jun 16;3:868300. doi: 10.3389/falgy.2022.868300. (2011) found that the number of treatment cycles with platinum-containing antineoplastic agents significantly correlates with the incidence of related hypersensitivity reactions. reactions to foreign proteins [generally immunoglobulin E (IgE)-mediated allergic responses] or non-immune-mediated reactions [1]. Allergy Asthma Proc (2011) 32(1):79.10.2500/aap.2011.32.3409 All funding for this site is provided directly by ESMO. Via Ginevra 4, 6900 Lugano - CH Copyright 2023 European Society for Medical Oncology All rights reserved worldwide. Carboplatin rechallenge after hypersensitivity reactions in pediatric patients with low-grade glioma. 105, 14721479. Note: Approved by the ESMO Guidelines Committee: July 2017, last update October 2022. . are hypersensitivity reactions that are systemic and can be life-threatening (Olsen et al., 2019; Rosell et al., 2017). -. doi: 10.1007/s00520-011-1123-y, Gomez, R., Harter, P., Lck, H. J., Traut, A., Kommoss, S., Kandel, M., et al. The incidence of carboplatin-related hypersensitivity was higher in patients with advanced stage disease (P < 0.001, Kruskal-Wallis test), serous and mixed histological types (P = 0.003, Kruskal-Wallis test), malignant ascites (P = 0.009, chi-square test), and history of other drug allergy (P < 0.001, chi-square test). Authors S Rosell 1 , I Blasco 1 , L Garca Fabregat 1 , A Cervantes 1 , K Jordan 2 ; ESMO Guidelines Committee Int. Thus, the risk of severe carboplatin-related hypersensitivity may influence its usage in gynecological cancers, and it is important to develop protocols to reduce this risk, especially the risk of severe reactions. Desensitization for hypersensitivity reactions to medications. eCollection 2017. (2005). Epub 2022 Nov 29. This was the largest series of gynecological malignancies investigated for carboplatin-related hypersensitivity reactions. 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Hoffmann-La Roche Ltd. H. Macharia: Non-Financial Interests, Personal, Research Grant, Medical writing support: F. Hoffmann-La Roche Ltd.; Financial Interests, Personal, Full or part-time Employment: F. Hoffman-La Roche. Median cycle and dose of carboplatin administered to women with or without hypersensitivity reactions. (2009) reported a 3.54% rate of severe carboplatin-related hypersensitivity reactions, which is similar to our rate of 2.2%. Carboplatin induces DNA double strand breaks, which are repaired by BRCA recombination repair enzymes. Clipboard, Search History, and several other advanced features are temporarily unavailable. Necessary cookies enable core functionality. Res. Cancer. Oncol. (PDF) Management of toxicities from immunotherapy: ESMO - ResearchGate ESMO is a Swiss-registered not-for-profit organisation. Similarly, a Japanese study found that carboplatin hypersensitivity occurred at a median of 11.5 cycles and 8,084.5 mg (Koshiba et al., 2009). ESMO Call to Action on COVID-19 Vaccinations and Patients with Cancer: Vaccinate. government site. doi: 10.1007/s10147-014-0731-1. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences. (2010) described the use of cisplatin as an alternative to carboplatin.
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