Oxaliplatin-based chemotherapy is extensively used for the treatment of gastrointestinal tumors and other malignancies. Oxaliplatin-related hypersensitivity reactions (HSRs) are common during antitumor treatment. Several studies have been conducted to identify predictive risk factors for oxaliplatin-related HSRs, but findings remain controversial. No definitive approach has been identified to reduce the risk of developing HSRs. The aim of this article is to provide an overview of oxaliplatin-related HSRs, and to report our institution's experience. With our work, we reviewed available data from the literature and described our case series. A total of 153 patients were treated with oxaliplatin and 17 developed an HSR. On the whole, 70.6% of reactions were Grade 3, mostly with respiratory and cutaneous symptoms. Steroids and antihistamines were administered to reduce hypersensitivity symptoms and prevent further reactions. A stronger premedication and prolonged time of infusion resulted in milder reactions or absence of subsequent reactions. We did not find any clear predictive factor for the development of HSRs. Although it is not possible to cancel the risk of oxaliplatin-based HSRs, strategies to reduce the risk of occurrence could be stronger premedication and prolonged time of infusion.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9775529PMC
http://dx.doi.org/10.3390/biomedicines10123275DOI Listing

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Article Synopsis
  • Recent cancer treatment strategies have shown improved efficacy but also lead to complex adverse effects, as evidenced by a case involving a 67-year-old male with gastric stump carcinoma.
  • The patient experienced severe symptoms including chills, high fever, and shock following treatment with a combination of chemotherapy and a PD-1 inhibitor, initially misdiagnosed as immune-related adverse events or a bacterial infection.
  • Ultimately, it was determined that a rare hypersensitivity reaction to oxaliplatin was the real cause of the patient's severe organ damage, highlighting the challenges in accurately diagnosing adverse events related to cancer treatments.
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Purpose: The National Comprehensive Cancer Network guidelines state that the oxaliplatin dose of 85 mg/m used in various gastrointestinal cancer regimens may be infused over a rapid rate of 85 min instead of the standard time of 120 min. We evaluated the safety outcomes of rapid administration of oxaliplatin compared to standard infusion.

Methods: We performed a retrospective, cohort study by chart review.

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Oxaliplatin-Related Hypersensitivity Reactions: A Single Institution Series and Literature Review.

Biomedicines

December 2022

Medical Oncology Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Oxaliplatin-based chemotherapy is extensively used for the treatment of gastrointestinal tumors and other malignancies. Oxaliplatin-related hypersensitivity reactions (HSRs) are common during antitumor treatment. Several studies have been conducted to identify predictive risk factors for oxaliplatin-related HSRs, but findings remain controversial.

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Background: Oxaliplatin is a third-generation platinum compound that has efficacy against colorectal cancer. Hypersensitivity reactions during oxaliplatin infusion are a key problem during its use, with the varying incidences and deficiencies of clearly identified risk factors.

Objective: To determine the incidence, severity and risk factors of oxaliplatin-related hypersensitivity reaction (HSR).

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Simplified Graded Infusion Strategy for Mitigation of Oxaliplatin Hypersensitivity.

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Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Address for correspondence: Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 E 66th Street, New York, NY 10065.

Background: Hypersensitivity reactions (HSRs) to oxaliplatin present a therapeutic challenge. The standard desensitization protocol consists of 12 infusion steps with 3 drug dilutions, often in an inpatient setting. Several years ago we implemented a simplified outpatient graded infusion protocol for oxaliplatin with 2 drug dilutions and 3 infusion steps.

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