Hypersensitivity Reactions to Oxaliplatin and the Application of a Desensitization Protocol

Abstract

Oxaliplatin (Eloxatin ® ; Sanofi-Synthelabo Inc.; New York, NY) is a third-generation platinum agent indicated for the treatment of colorectal cancer. Severe hypersensitivity reactions to oxaliplatin rarely occur; however, they do represent a threat to the small number of patients that are occasionally affected. We developed a desensitization protocol and successfully applied it to a patient with severe, grade 3, hypersensitivity to oxaliplatin. For patients who have mild sensitivity to oxaliplatin, slowing the run rate down and giving an antihistamine and/or a steroid usually suffice. Desensitization will help to provide the small number of patients who experience severe hypersensitivity reactions with the ability to further receive an effective therapy for their colorectal cancer. The desensitization protocol is described in detail. The Oncologist

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

“…In the case of grade 3 or 4 reactions, patients should not be given the same treatment without modifications. In the event of mild-to-moderate reactions, any reintroduction of the drug could lead to a severe or even lethal reaction 72 . In such cases, a desensitization protocol should be planned 2 .…”

Oxaliplatin induced disseminated intravascular coagulation: A case report and review of literature

“…After disease progression despite multiple lines of palliative chemotherapy, rechallenge with Oxaliplatin became the best therapeutic option. The desensitization protocol [5] went well with no untoward reactions to mFOLFOX6 and bevacizumab infusion. However during her second (with bevacizumab) and third (without bevacizumab) cycles of mFOLFOX 6 the patient developed DIC.…”

“…Such patients can undergo a desensitization protocol which may be effective, and help the patients to continue to receive the drug [5] . We believe that this is the first reported case of DIC associated with Oxaliplatin infusion.…”

Putting Evidence Into Practice

“…Successful case reports of desensitization to oxaliplatin have been reported after severe reactions (Gammon, Bhargava, & McCormick, 2004;Meyer, Zuberbier, Worm, Oettle, & Riess, 2002), although some investigators have proposed that patients who develop a severe reaction are unlikely to tolerate additional doses of oxaliplatin (Thomas et al, 2003). Intradermal testing is one method that can be used to predict hypersensitivity reactions with oxaliplatin (Garufi et al, 2003).…”