J. Med. Unable to load your collection due to an error, Unable to load your delegates due to an error. Gender, age, ethnicity and race were similar between subgroups as were objective response rates (ORR) (64% CPI-treated v 62% CPI-nave). Oncol. Incidence and intensity of anaphylaxis/hypersensitivity events: Table: 138P 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. J. Gynecol. The results of the trial could answer whether carboplatin hypersensitivity patients have similar chemo-responses in non-platinum regimens without compromising the efficacy of the antineoplastic regimens of these patients. Prior to an infusion of a mAb, nurses should do the following (Olsen et al., 2019): . (2011) found that the number of treatment cycles with platinum-containing antineoplastic agents significantly correlates with the incidence of related hypersensitivity reactions. WHIPPANY, N.J., Sept. 1, 2017 /PRNewswire/ -- Bayer will present the latest research from across its growing oncology portfolio at the European Society for Medical Oncology (ESMO) 2017 Congress . Carriers of BRCA genes develop drug allergy after fewer exposures and can present with severe reactions, including anaphylaxis. Leuk Lymphoma. Patients with prior drug or food allergies should be closely monitored during carboplatin administration. Unauthorized use of these marks is strictly prohibited. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. In the late 1980s, more than a dozen phase I studies analyzed the efficacy of paclitaxel as a single agent. CA. Gynecol. Upon the occurrence of symptoms and signs, carboplatin infusion was immediately stopped. Create your own personalised agenda and browse the complete scientific programme by day, topic, cancer type and track with the ESMO events app. The site is secure. Parmar et al. MINIMAL Requirements:Google Chrome 24+,Mozilla Firefox 20+,Internet Explorer 11,Opera 1518,Apple Safari 7,SeaMonkey 2.15-2.23, Published in 2020 Ann Oncol (2020)Authors:M.E. Cancer 63, 2126. These patients were provided with intravenous fluid infusion and medications, including corticosteroids, antihistamines, and oxygen application. 105, 14721479. doi: 10.1200/JCO.2009.25.7519, Schwartz, J. R., Bandera, C., Bradley, A., Brard, L., Legare, R., Granai, C. O., et al. There is evidence that inhibitory mechanisms blocking IgE/antigen mast cell activation are active during desensitization, enhancing safety. (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. Symptoms and signs of 75 patients with hypersensitivity reactions to carboplatin. Characteristics of the 735 women receiving carboplatin-based chemotherapy. 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. Diagnoses and Management of Drug Hypersensitivity and Anaphylaxis in Cancer and Chronic Inflammatory Diseases: Reactions to Taxanes and Monoclonal Antibodies. doi: 10.1007/s00280-009-1159-6, Iwamoto, T., Hirai, H., Yamaguchi, N., Kobayashi, N., Sugimoto, H., and Tabata, T. (2014). Check the latest publications and updates here to make sure you dont miss anything. Carboplatin-related hypersensitivity reactions were defined as symptoms and signs occurring minutes to hours after carboplatin administration. Critical revision: C-AC. Via Ginevra 4, 6900 Lugano - CH Copyright 2023 European Society for Medical Oncology All rights reserved worldwide. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences. and transmitted securely. Educate. TABLE 3 Table 3. Unable to load your collection due to an error, Unable to load your delegates due to an error. (2010) described the use of cisplatin as an alternative to carboplatin. Enhancing the feasibility of outpatient daratumumab administration via a split-dosing strategy with initial doses. Hypersensitivity reactions to carboplatin administration are common but not always severe: a 10-year experience. Login to your ESMO account to sign up for ESMO newsletters and receive information about ESMO's scientific and educational resources, events, member benefits. Among 735 eligible women, 75 (10.2%) experienced a total of 215 carboplatin-related hypersensitivity reaction events. (2003). 2017;40(3):120-127. doi: 10.1159/000458443. The overall safety of desensitization for common chemotherapy drugs and monoclonal antibodies. Chemother. We also collected survey data from cancer nurses on safety . 17 This dose reduction is due to the ability of both aprepitant and netupitant to inhibit the metabolism of dexamethasone leading to higher . Yamamoto A, Kamoi S, Matsuda S, Kawase R, Nakanishi K, Suzuki S. Medicines (Basel). 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. The .gov means its official. Authors: S. Rosell, I. Blasco, L. Garca Fabregat, A. Cervantes and K. Jordan Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. ESMO 2017 was held in partnership with the European Association for Cancer Research (EACR) in Madrid . The cumulative incidence of severe carboplatin-related hypersensitivity was 1% after 15 cycles and 2% after 24 cycles, with a plateau beyond this cycle number, and 1% at >7,500 mg and 2% at >12,500 mg, with a plateau beyond this dose (Figures 1A,B). Pharmacol. doi: 10.1006/gyno.2001.6519, Gadducci, A., Tana, R., Teti, G., Zanca, G., Fanucchi, A., and Genazzani, A. R. (2008). 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. Clinical features and management of carboplatin-related hypersensitivity reactions in pediatric low-grade glioma. Haanen JBAG, Carbonnel F, Robert C, Kerr KM, Peters S, Larkin J, Jordan K; ESMO Guidelines Committee. hypersensitivity and pneumonitis not otherwise specified. Oncol. Int. (2013). Abe et al. However, 48 (78.7%) of these patients developed repeated hypersensitivity reactions, even after pre-treatment with intravenous antihistamines, H2 blocker, and corticosteroids prior to carboplatin re-administration. Therefore, disease severity, histological type, malignant ascites, past drug allergies, and cumulative carboplatin dose are risk factors for carboplatin-related hypersensitivity reactions. Via Ginevra 4, 6900 Lugano - CH Copyright 2023 European Society for Medical Oncology All rights reserved worldwide. Pediatric. Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly. We analyzed the incidence, characteristics, risk factors, management, and outcomes of carboplatin-related hypersensitivity reactions among these patients. However, prolonged carboplatin use is associated with an increased incidence of carboplatin-related hypersensitivity reactions (Markman et al., 1999; Wang et al., 2009). The independent sample t-test was used to evaluate how carboplatin cycle and dose correlated with the incidence of hypersensitivity and severe hypersensitivity reactions. Monitor. Necessary cookies enable core functionality. MINIMAL Requirements:Google Chrome 24+,Mozilla Firefox 20+,Internet Explorer 11,Opera 1518,Apple Safari 7,SeaMonkey 2.15-2.23. Cancer 15, 1318. Epub 2019 Jul 3. Putative mechanism of protection against anaphylaxis during human desensitizations. Clin Rev Allergy Immunol. doi: 10.1111/IGC.0b013e3181a418ff, Greene, D. P., Ferriss, J. S., and Jazaeri, A. 66, 265267. Careers. 2022 Mar 30;9(4):26. doi: 10.3390/medicines9040026. 2017 Nov 8;8:1472. doi: 10.3389/fimmu.2017.01472. 24, 2432. We also provide recommendations for the continuation of treatment in ovarian cancer patients. Ann Oncol. Background Hypersensitivity reactions (HSRs) are sometimes associated with the administration of certain cancer drugs. (2012) demonstrated that carboplatin treatment can be continued successfully in patients whose hypersensitivity reactions are managed in a timely fashion. A history of drug or food allergy, the presence of malignant ascites, and the cumulative carboplatin dose are three independent predictive factors of carboplatin hypersensitivity in this survey. Before In Taiwan, carboplatin was first introduced for the treatment of ovarian cancer in 2004. The rate of hypersensitivity was significantly higher among patients with advanced stage disease (IIIIV) compared to patients with early stage disease (III) (P < 0.001, Kruskal-Wallis test), and among patients with serous or mixed histological type compared to patients with other histological types (P = 0.003, Kruskal-Wallis test). doi: 10.1093/annonc/mdt333. However, severe carboplatin-related hypersensitivity symptoms can be fatal, as in one of our cases. Among the 651 women (88.6%) diagnosed with ovarian cancer, 474 (64.5%) had stage IIIIV disease. Supportive and palliative care are areas of high importance in oncology and ESMO published Clinical Practice Guidelines on the management of a variety of issues: Palliative Care in the COVID-19 era, Advanced Care Planning, Anaemia and Iron Deficiency in Patients With Cancer, Anxiety and Depression,Bone Health in Cancer Patients, Cancer Cachexia in Adult Patients, Cancer Pain, Cancer-related Fatigue,Care at the End of Life, Central Venous Access in Oncology, Chemotherapy Extravasation, Constipation in Advanced Cancer, Delirium in Adult Cancer Patients,Diarrhoea in Adult Cancer Patients, Infusion Reactions to Systemic Anticancer TherapyFebrile Neutropaenia, Fertility Preservation and Post-treatment Pregnancies in Post-pubertal Cancer Patients, Management of Breathlessness in Patients with Cancer,Management of Cardiac Disease, Management of Orphan Symptoms, Neurotoxicity,Oral and Gastrointestinal Mucosal Injury, Prevention and Management of Dermatological Toxicities Related to Anticancer Agents, Prevention of Chemotherapy and Radiotherapy-Induced Nausea and Vomiting, Prognostic Evaluation in Advanced Cancer,Role of Patient-reported Outcome Measures, Toxicities from immunotherapy and Venous Thromboembolism in Cancer Patients. (2016). 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. The annual incidence of carboplatin-related hypersensitivity reactions gradually increased from 0.88% in 2006 to 5.42% in 2013. J. Clin. 4 - 9 Without premedication, hypersensitivity reactions (HSRs) occurred in 25%-30% of patients in these studies and clinical development of paclitaxel was consequently delayed. The total incidence of carboplatin-related hypersensitivity was 3.21% by the cycle of carboplatin. (1994). Bookshelf Gynecol. The overall safety profile was similar between subgroups. Markman, M. (2007). Chan. The drug or food allergy in 735 patients receiving carboplatin-based chemotherapy. ESMO is a Swiss-registered not-for-profit organisation. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). 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. For more detailed information on the cookies we use, please check our Privacy Policy. 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. All accepted abstracts are available in theESMO 2017 Abstract Book. Life expectancy for cancer patients allergic and desensitized to carboplatin and non-allergic to carboplatin [from Sloane et al. 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). Educate. These new ESMO Clinical Practice Guidelines provide tools to evaluate the risk of infusion reactions, to recognise the early signs and symptoms and include recommendations on how to document and manage them. Morgan C, Tillett T, Braybrooke J, Ajithkumar T. Lancet Oncol. 21, 31943200. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 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. In the majority of ovarian cancer cases, primary management entails surgical staging or cytoreduction, followed by systemic chemotherapy (Ledermann et al., 2013). Prevention and Treatment of Side Effects of Immunotherapy for Bladder Cancer. S M S, Naveen NR, Rao GK, Gopan G, Chopra H, Park MN, Alshahrani MM, Jose J, Emran TB, Kim B. Reactions to taxenes including paclitaxel and docetaxel present with pain as a neuromuscular symptoms in up to 4% of the patients. 19, 460465. Hypersensitivity reactions associated with platinum-containing antineoplastic agents for thoracic malignancies. For more detailed information on the cookies we use, please check our Privacy Policy. All of these reported symptoms and signs occurred within an hour of initiating carboplatin administration. Symptoms and signs of hypersensitivity reactions amendable to desensitization. Login to your ESMO account to sign up for ESMO newsletters and receive information about ESMO's scientific and educational resources, events, member benefits. ESMO is a Swiss-registered not-for-profit organisation. (2001). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Close monitoring is warranted for patients with a history of drug or food allergy, malignant ascites, or cumulative carboplatin dose >4,000 mg. Strategies for preventing carboplatin-related hypersensitivity include reducing the carboplatin infusion rate and employing desensitization protocols with anti-allergy medications. Prior investigations reported that a history of drug allergies correlates with the incidence of carboplatin-related hypersensitivity reactions (Libra et al., 2003; Sliesoraitis and Chikhale, 2005). Here's a summary of the new ESMO guidelines in 5 key areas: . J. Gynecol. A., Raja, F. A., Fotopoulou, C., Gonzalez-Martin, A., Colombo, N., Sessa, C., et al. In addition, the development of a new generation of platinum cytotoxic drugs to avoid hypersensitivity reactions is warranted. A total of 59 women experienced mild signs and symptoms (grades 1 and 2), including skin rash (69.3%), skin itching (64.0%), facial flushing (56.0%), dyspnea (41.3%), chest pain (25.3%), tachycardia (18.7%), paresthesias (16.0%), abdominal cramping (13.3%), and diaphoresis (12.0%). Cancer 19, 12841287. The ESMO Congress is the most influential annual meeting for oncology professionals in Europe. Though the characteristics of carboplatin-related hypersensitivity reactions are widely reported, limited data are available regarding such reactions in different types of patients. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. Platinum desensitization in patients with carboplatin hypersensitivity: a single-institution retrospective study. Univariate analysis for potential risk factors of carboplatin-related hypersensitivity reactions were assessed by the chi-square or Kruskal-Wallis test for categorical variables. This site needs JavaScript to work properly. doi: 10.1093/annonc/mdx225. 3, 10 In subsequent trials, 11 - 16 patients were premedicated The left side, Putative mechanism of protection against, Putative mechanism of protection against anaphylaxis during human desensitizations. 24, 342351. We also recorded the procedures applied to treat the hypersensitivity reactions and efforts to manage the side effects of carboplatin administration. ESMO Clinical Practice Guidelines Provide your patients with the best care options Supporting your clinical decisions with ESMO's regularly updated Clinical Practice Guidelines and consensus recommendations, developed by the leading experts in our profession. Drug Interactions in the Treatment of Malignancy in HIV-Infected Patients. 2022 Apr 26;14(4):e24515. 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Would you like email updates of new search results? Table 2. However, basophil activation has been observed in patients with a history of severe carboplatin hypersensitivity reaction (Iwamoto et al., 2014). Gynecol. This site uses cookies. Cancer. We further evaluated the median carboplatin cycle and dose administered to women with and without carboplatin-related hypersensitivity. J. Clin. With a lower carboplatin infusion rate and pre-treatment with anti-allergy drugs, all of these patients were able to tolerate re-treatment with carboplatin, although 48 (78.7%) of these 61 patients developed hypersensitivity again despite the desensitization protocol. Such reactions were scored according to the Common Terminology Criteria for Adverse Events version 4.03, with severity assessed as mild (grades 1 and 2) or severe (grades 3 and 4). Necessary cookies enable core functionality. FOIA Please enable it to take advantage of the complete set of features! Curr Allergy Asthma Rep. 2023 Jan;23(1):1-11. doi: 10.1007/s11882-022-01052-z. Altwerger et al. This was the largest series of gynecological malignancies investigated for carboplatin-related hypersensitivity reactions. For more detailed information on the cookies we use, please check our Privacy Policy. Pharmacol. Met Based Drugs (2010) 2010 Available from: Markman M. Toxicities of the platinum antineoplastic agents. J. Gynecol. Analysis included treatment cycle, causative drug, severity of reaction as per CTCAE v4 . Clinical features of hypersensitivity reactions to carboplatin. 57 . 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). Platinum agent-induced hypersensitivity reactions: data mining of the public version of the FDA adverse event reporting system, AERS. S.M. Login to your ESMO accountto sign up for ESMO newsletters and receive information about ESMO's scientific and educational resources, events, member benefits. Challenges in the Development of Intravenous Neurokinin-1 Receptor Antagonists: Results of a Safety and Pharmacokinetics Dose-Finding, Phase1 Study of Intravenous Fosnetupitant. All funding for this site is provided directly by ESMO. 105, 8183. Most events occurred during chemotherapy. Drafting of manuscript: Y-HT and W-FC. 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 Analysis of the pattern of hypersensitivity reactions in patients receiving carboplatin retreatment for recurrent ovarian cancer. Accessibility Evaluating whether any factors can predict carboplatin hypersensitivity, we identified a high correlation with the carboplatin cycle and cumulative dose (Pearson correlation coefficient 0.9318). This review provides insight into the current knowledge of drug allergy and anaphylaxis to cancer and chronic inflammatory diseases drugs, the mechanisms of drug desensitization and its applications to personalized medicine. This patient developed hypersensitivity reactions during her 23rd cycle of carboplatin administration at a cumulative dose of approximately 14,000 mg. She experienced skin rash, tachycardia, and dyspnea 13 min after starting the infusion. ESMO Call to Action on COVID-19 Vaccinations and Patients with Cancer: Vaccinate. MINIMAL Requirements:Google Chrome 24+,Mozilla Firefox 20+,Internet Explorer 11,Opera 1518,Apple Safari 7,SeaMonkey 2.15-2.23. Zhonghua. 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. 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). ESMO Call to Action on COVID-19 Vaccinations and Patients with Cancer: Vaccinate. A total of 735 eligible women who underwent treatment for ovarian, fallopian tube, or primary peritoneal cancer were recruited this the study; 75 (10.2%) experienced a total of 215 carboplatin-related hypersensitivity reaction events. 44, 837840. 2022 Oct 18;12:994155. doi: 10.3389/fonc.2022.994155.
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