Hypersensitivity Reactions to Platinum Agents and Taxanes

Hypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions through an immunologic mechanism have been established for platinum and taxane agents, which are used to treat a wide variety of ca...

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Bibliographic Details
Published in:Clinical reviews in allergy & immunology 2022-06, Vol.62 (3), p.432-448
Main Authors: Tsao, Lulu R., Young, Fernanda D., Otani, Iris M., Castells, Mariana C.
Format: Article
Language:English
Subjects:
Allergic reaction
Allergology
Allergy
Antimitotic agents
Antineoplastic agents
Antineoplastic Agents - adverse effects
Cancer
Care and treatment
Chemotherapy
Desensitization, Immunologic - methods
Drug Hypersensitivity - diagnosis
Drug Hypersensitivity - epidemiology
Drug Hypersensitivity - etiology
Epidemiology
Female
Humans
Hypersensitivity
Immunoglobulin E
Immunology
Internal Medicine
Medicine
Medicine & Public Health
Neoplasms - drug therapy
Patients
Platinum
Platinum - adverse effects
Skin
Skin Tests
Taxanes
Taxoids - adverse effects
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Summary:Hypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions through an immunologic mechanism have been established for platinum and taxane agents, which are used to treat a wide variety of cancers including gynecologic cancers. Platin HSRs typically occur after multiple cycles of chemotherapy, reflecting the development of drug IgE sensitization, while taxane HSRs often occur on first or second exposure. Despite observed differences between platin and taxane HSRs, drug desensitization has been an effective method to reintroduce both chemotherapeutic agents safely. Skin testing is the primary diagnostic tool used to risk-stratify patients after initial HSRs, with more widespread use for platinum agents than taxanes. Different practices exist around the use of skin testing, drug challenge, and choice of desensitization protocol. Here, we review the epidemiology, mechanism, and clinical presentation of HSRs to platinum and taxane agents, as well as key controversies in their evaluation and management.
ISSN:1559-0267
1080-0549
1559-0267
DOI:10.1007/s12016-021-08877-y