PH IV/PH FDC SC is standard of care for HER2-positive BC and usually given with chemotherapy, all of which can trigger anaphylaxis/hypersensitivity. Cancer. Genc et al. doi: 10.1159/000055363, Pujade-Lauraine, E., Wagner, U., Aavall-Lundqvist, E., Gebski, V., Heywood, M., Vasey, P. A., et al. Cancer 104, 640643. Markman, M. (2007). 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. Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly. eCollection 2022. Educate. BRCA1/2 mutation has been reported to correlate with carboplatin hypersensitivity (Altwerger et al., 2017). Login to your ESMO account to sign up for ESMO newsletters and receive information about ESMO's scientific and educational resources, events, member benefits. doi: 10.1093/annonc/mdy158. National Library of Medicine Statistical analyses were performed using the Statistical Package of Social Studies (SPSS) version 17.0 (SPSS, Inc., Chicago, IL) and SAS software version 9.4 (SAS Inc, NC, USA) for Windows. Management of infusion reactions to systemic anticancer therapy: ESMO Clinical Practice Guidelines (2017) 8 Pager Instructions Coverage Begins March 1, 2019 Coverage Ends: TBD 1. . Carboplatin and pegylated liposomal doxorubicin (Pujade-Lauraine et al., 2010) or gemcitabine (Pfisterer et al., 2006) led to superior progression-free survival of patients with platinum-sensitive recurrent ovarian cancer compared to paclitaxel and carboplatin. 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. The most commonly exhibited symptom/sign was hypotension (10.7%), followed by anaphylaxis (8.0%) and desaturation (6.7%). J. Clin. Drug allergy is a rising problem in the twenty-first century which affects all populations and races, children, and adults, and for which the recognition, diagnosis, management, and treatment is still not well standardized. Prevention and Treatment of Side Effects of Immunotherapy for Bladder Cancer. J Investig Allergol Clin Immunol. NCT00567190, NCT02402712, NCT01358877, NCT00545688, NCT00976989, NCT02132949, NCT03493854, NCT03674112. To assist those using and/or evaluating the ESMO Guidelines, download the methodology here, Download the new version of our App with the latest Pocket Guidelines for oncology professionals. 18, 615620. The median patient age was 56 years (range 1694 years). All accepted abstracts are available in theESMO 2017 Abstract Book. Lancet 361, 20992106. Before 107, 163165. The overall safety of desensitization for common chemotherapy drugs and monoclonal antibodies. Ke. (1999). Drug Interactions in the Treatment of Malignancy in HIV-Infected Patients. Desensitization is a high risk procedure in which a drug is administrated to a patient who has already presented an allergic reaction, almost always severe. By delivering the target, Symptoms and signs of hypersensitivity reactions amendable to desensitization. Unauthorized use of these marks is strictly prohibited. Optimal debulking surgery was performed in 491 patients (66.8%). This site uses cookies. MINIMAL Requirements:Google Chrome 24+,Mozilla Firefox 20+,Internet Explorer 11,Opera 1518,Apple Safari 7,SeaMonkey 2.15-2.23. Monitor. 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). (2016). Carboplatin hypersensitivity: evaluation and successful desensitization protocol. Median cycle and dose of carboplatin administered to women with or without hypersensitivity reactions. Whether desensitization modulates drug allergic and anaphylactic responses facilitating tolerance is currently being investigated. 17 This dose reduction is due to the ability of both aprepitant and netupitant to inhibit the metabolism of dexamethasone leading to higher . Pharmacol. Cancer 20, 385393. Wang, H. B., Shen, K., Yang, J. X., Huang, H. F., Li, Y., Wu, M., et al. Management of infusion reactions to systemic anticancer therapy: ESMO Clinical Practice Guidelines. doi: 10.3322/caac.21332, Sliesoraitis, S., and Chikhale, P. J. Analysis of patients with epithelial ovarian cancer or fallopian tube carcinoma retreated with cisplatin after the development of a carboplatin allergy. EHA Endorsement of ESMO Clinical Practice Guidelines for Diagnosis, Treatment, and Follow-up for Myelodysplastic Syndromes. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences. An official website of the United States government. Patients with prior drug or food allergies should be closely monitored during carboplatin administration. Note: Approved by the ESMO Guidelines Committee: July 2017, last update October 2022. . Background Hypersensitivity reactions (HSRs) are sometimes associated with the administration of certain cancer drugs. We performed tests on occupational exposure (from 10 different health care surfaces) from three types of chemotherapy (Cyclophosphamide, Gemcitabine and Fluorouracil) from three different hospitals in Sweden. The cumulative incidence of carboplatin-related hypersensitivity reactions increased with the number of carboplatin cycles (Figure 1A) and increasing dose (Figure 1B), especially at >8 cycles or a dose >3,500 mg. Allergy Asthma Proc (2011) 32(1):79.10.2500/aap.2011.32.3409 doi: 10.1006/gyno.1994.1098, Keywords: ovarian cancer, chemotherapy, carboplatin, hypersensitivity, risk factor, Citation: Tai Y-H, Tai Y-J, Hsu H-C, Lee S-P, Chen Y-Y, Chiang Y-C, Chen Y-L, Chen C-A and Cheng W-F (2017) Risk Factors of Hypersensitivity to Carboplatin in Patients with Gynecologic Malignancies. (2007). J Exp Clin Cancer Res (2011) 30:93.10.1186/1756-9966-30-93 Challenges in the Development of Intravenous Neurokinin-1 Receptor Antagonists: Results of a Safety and Pharmacokinetics Dose-Finding, Phase1 Study of Intravenous Fosnetupitant. Most anticancer treatments carry a risk for infusion reactions which incidence may increase when different agents are administered concomitantly. A three-step method was developed to identify hypersensitivity reactions, including anaphylaxis, in a clinical trial database and could be applied to investigational drugs to improve early detection and monitoring of potential safety concerns, subsequent patient safety management strategies, and potentially programme-wide drug development A sincere thanks to the almost 24,000 participants who attended this year's annual congress! Annals of Oncology (2021) 32 (suppl_5): S407-S446. Desensitization for hypersensitivity reactions to medications. eCollection 2022. Epub 2022 Nov 29. Similarly, Kandel et al. 24, 342351. Ann. Carboplatin-related hypersensitivity reactions were defined as symptoms and signs occurring minutes to hours after carboplatin administration. Prevention and Management of Dermatological Toxicities Related to Anticancer Agents: ESMO Clinical Practice Guidelines. LBA10004 The full, final text of this abstract will be available at abstracts.asco.org at 2:00 PM (EDT) on Friday, June 2, 2017, and in the Annual Meeting Proceedings online supplement to the June . doi: 10.1111/j.1525-1438.2005.00136.x, Koshiba, H., Hosokawa, K., Kubo, A., Miyagi, Y., Oda, T., Miyagi, Y., et al. eCollection 2022 Apr. Webcasts and presentations from ESMO 2017 can be accessed by ESMO members and event attendees. Severe carboplatin-related hypersensitivity reactions are uncommon. Most IRs are mild with symptoms such as chills, fever, nausea, headache, skin rash, pruritus, etc. Carboplatin and other paltins such as cisplatin and oxaliplatin reactions include classical symptoms of anaphylaxis with cutaneous, respiratory, cardiovascular, and gastrointestinal symptoms. (2010). Nektaria M, Ekaterini S, Ioannis K, Leonidas M, Muhammad Wasif S. Hypersensitivity reactions associated with platinum antineoplastic agents: a systematic review. (2005). 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). To overcome drug allergy, desensitization has been developed, a novel approach which provides a unique opportunity to protect against anaphylaxis and to improve clinical outcomes. Would you like email updates of new search results? These patients were provided with intravenous fluid infusion and medications, including corticosteroids, antihistamines, and oxygen application. hypersensitivity and pneumonitis not otherwise specified. Symptoms and signs of 75 patients with hypersensitivity reactions to carboplatin. Discontinuations due to anaphylaxis/hypersensitivity were rare for PH IV (generally <1% except two TRYPHAENA arms: 1% and 3%); no discontinuations of PH FDC SC have been recorded so far. Koshiba et al. Monitor. Clinical practice guidance in a modernised format that focuses on visual representation of recommendations for quick and easy reference by practicing clinicians. Furthermore, patients with carboplatin hypersensitivity had a higher incidence of previous allergic history to other cytotoxic drugs, including gemcitabine, paclitaxel, and doxorubicin, compared to those without (12/75 vs. 30/660, P < 0.001, chi-squared test; Table 7). Paclitaxel plus platinum-based chemotherapy vs. conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. All funding for this site is provided directly by ESMO. Most events occurred during chemotherapy. A spotlight on alkaloid nanoformulations for the treatment of lung cancer. 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All funding for this site is provided directly by ESMO. Doxorubicin/adriamycin and other chemotherapies present with sudden onset hypo or hypertension in up to 60% of patients and rituximab and other monoclonal antibodies present with cutaneous and cardiovascular symptoms in 70% of the patients. Multivariate analyses of clinical parameters for carboplatin-related hypersensitivity reactions. In the US, PH FDC SC can be administered by healthcare professionals in patients (pts) homes. Life expectancy for cancer patients allergic and desensitized to carboplatin and non-allergic to carboplatin [from Sloane et al. Abe et al. Incidence of carboplatin-related hypersensitivity reactions in Japanese patients with gynecologic malignancies. Published in 2020 - Ann Oncol (2020) Authors: M.E. 144, 7782. Carboplatin-related hypersensitivity reactions sometimes result in premature discontinuation of treatment (Schwartz et al., 2007). Int. Report of three cases. doi: 10.1007/s10147-014-0731-1. Efficacy and Adverse Events of Carboplatin Desensitisation Therapy for Gynaecological Cancer: A Retrospective Study. We also found higher rates of hypersensitivity among patients with malignant ascites compared to patients without malignant ascites (P = 0.009, chi-squared test), and in patients who had experienced allergic reactions to other medications or food (e.g., paclitaxel, penicillin, aspirin) compared to patients who had not experienced previous allergic reactions (P < 0.001, chi-squared test). *Correspondence: Wen-Fang Cheng, wenfangcheng@yahoo.com, Creative Commons Attribution License (CC BY). A cumulative search for anaphylaxis/hypersensitivity (Roche Standard Adverse Event Group Terms) across all pivotal trials cited in the current EMA P IV/PH FDC SC SmPCs. Shah et al. doi: 10.1111/j.1525-1438.2007.01063.x, Genc, D. B., Canpolat, C., and Berrak, S. G. (2012). Care. We also recorded the procedures applied to treat the hypersensitivity reactions and efforts to manage the side effects of carboplatin administration. doi: 10.1200/JCO.1999.17.4.1141, Moon, D. H., Lee, J. M., Noonan, A. M., Annunziata, C. M., Minasian, L., Houston, N., et al. The overall safety profile was similar between subgroups. This site needs JavaScript to work properly. We retrieved clinical information, including age, menopausal status, cancer stage, surgical findings, chemotherapeutic treatment history, recurrence status, and survivorship, from the clinical and operative notes and discharge summaries stored in a centralized database. 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. Int J Med Sci (2011) 8(4):3328.10.7150/ijms.8.332 doi: 10.2152/jmi.57.163, PubMed Abstract | CrossRef Full Text | Google Scholar, Altwerger, G., Gressel, G. M., English, D. P., Nelson, W. K., Carusillo, N., Silasi, D. A., et al. Thus, we chose the cumulative carboplatin dose for the analysis to avoid interference between the highly correlated factors. Evaluation of the incidence of carboplatin hypersensitivity in cancer patients. Cardiopulmonary resuscitation and endotracheal intubation were performed, but the patient finally expired due to respiratory failure. Authorship includes a multidisciplinary group of experts from different institutions and countries in Europe and abroad. The incidence of carboplatin-related hypersensitivity correlated with cycle number and dose, with the first episode occurring at a median of 12 cycles and 6,816 mg. Via Ginevra 4, 6900 Lugano - CH Copyright 2023 European Society for Medical Oncology All rights reserved worldwide. J. Gynecol. Same-Day Desensitization in Patients Who Experience Their First Reaction to a Platin Agent at the Oncology Day Unit: A Pilot Study to Safely Include This Technique Within the Multidisciplinary Pathways for the Diagnosis & Management of Hypersensitivity to Platin Agents. Although infusion reactions can be allergic or non-immune-mediated, the clinical manifestations are the same and require prompt assessment and appropriate intervention. (2015). We evaluated the prevalence of and risk factors for hypersensitivity reactions related to carboplatin, which is commonly used to treat gynecological malignancies. These ESMO Clinical Practice Guidelines provide recommendations on the prevention/management of dermatological toxicities. The site is secure. Author Mariana Castells 1 Affiliation 1 Allergy and Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. Markman et al. Oncol. Fu. Login to your ESMO account to sign up for ESMO newsletters and receive information about ESMO's scientific and educational resources, events, member benefits. Reactions to taxenes including paclitaxel and docetaxel present with pain as a neuromuscular symptoms in up to 4% of the patients. 2019 Nov;15(11):e925-e933. Zhonghua. 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Oncol. Access all the congress resources: webcasts, news, press, posters, videos and much more. (Markman, 2007) reported that carboplatin-related hypersensitivity reactions rarely occur before cycle 6 or <3,000 mg of drug delivery, with the first episode most commonly occurring with carboplatin administration in the second-line setting, and carboplatin administration beyond 9 cycles or 6,000 mg increasing the risk of severe hypersensitivity reactions, similar to our present observations. However, other studies have reported severe hypersensitivity reactions to cisplatin in patients with prior carboplatin hypersensitivity reactions (Zweizig et al., 1994; Dizon et al., 2002). 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. 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. J. Clin. doi: 10.1200/JCO.2003.02.153, Parmar, M. K., Ledermann, J.
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