High-dose dexamethasone plus antihistamine prevents colorectal cancer patients treated with modified FOLFOX6 from hypersensitivity reactions induced by oxaliplatin

Abstract

Increased doses of dexamethasone and antihistamine significantly reduced oxaliplatin-related hypersensitivity reactions. This effective approach should be considered for all patients who receive FOLFOX, allowing treatment to be completed as planned.

Hypersensitivity Reactions to Oxaliplatin: Clinical Features and Risk Factors in Koreans

“…Hypersensitivity reactions during oxaliplatin infusion are major problem associated with its use (Kidera et al, 2011). Hypersensitivity reactions can be the cause of discontinuation of oxaliplatin infusion.…”

“…Hypersensitivity reactions can be the cause of discontinuation of oxaliplatin infusion. There have been limited reports on the characteristics and the risk factors of oxaliplatin-related hypersensitivity reactions, and adverse reactions would be important with extensive use of oxaliplatin (Kidera et al, 2011;Kim et al, 2009;Polyzos et al, 2009;Shao et al, 2010;Shibata et al, 2009). In addition, there is not perfect tool to predict oxaliplatin-related hypersensitivity reactions.…”

“…It has been reported that prophylactic regimens with corticosteroids and antihistamines are successful although effective prophylactic regimen of dexamethasone has not been determined (Bhargava et al, 2004;Brandi et al, 2003;Gowda et al, 2004;Lim et al, 2004;Maindrault-Goebel et al, 2005;Thomas et al, 2003). In a recent study, it has been reported that high dose dexamethasone plus antihistamine prevented colorectal cancer patients treated with modified FOLFOX-6 from hypersensitivity reaction to oxaliplatin (Kidera et al, 2011). In other study, high dose dexamethasone (20mg) and low dose dexamethasone (8mg) were compared to evaluate the prophylactic effect to hypersensitivity reactions (Markman et al, 1999).…”

“…There are few reports on the risk factors of oxaliplatin hypersensitivity (Lee et al, 2006;Kim et al, 2009; 1210 Polyzos et al, 2009;Shao et al, 2010;Kidera et al, 2011). Kim et al (2009) investigated risk factors of hypersensitivity reactions, and younger age, female, and with use of oxaliplatin as salvage therapy were suggested as potential risk factors.…”

Management of Hypersensitivity to Platinum- and Taxane-Based Chemotherapy: cepo Review and Clinical Recommendations

“…A small retrospective study showed that premedication (diphenhydramine, dexamethasone, granisetron, and famotidine vs. dexamethasone and granisetron) reduced hypersensitivity reactions associated with modified folfox6 (leucovorin, 5-fluorouracil, oxaliplatin) 46 . In the case of a grade 1 or 2 hypersensitivity reaction, it is possible to continue oxaliplatin treatment without reducing the infusion rate if the patient is premedicated with dexamethasone 47 .…”