Oxaliplatin Allergy Is Not Always What It Seems: A Case Report

Abstract

Hypersensitivity reactions to chemotherapy agents (HRC) are an increasing problem that limits patients' therapeutic options, needing to change to second line treatments, therefore decreasing quality of life and life expectancy. Fortunately, during the last decade drug desensitization protocols have been developed, allowing patients to receive first line treatment, minimizing risks and increasing life expectancy [1]. Even when patients with severe drug reactions cannot be managed despite adequately modified desensitization protocols, the use of Omalizumab can help to achieve tolerance [2]. Common classification for drug hypersensitivity reactions (HSRs) corresponds to Gell and Coombs classification: Type I (IgE mediated), Type II, (antibody mediated cytotoxicity reactions), Type III (immune complex-mediated reactions), and Type IV for delayed type hypersensitivity [3]. However, this classification does not correlate with actual spectrum of reactions experienced by some patients with HSRs [4,5] reason why a new approach based on precision medicine through phenotypes, endotypes and biomarkers has been proposed [3-7] encompassing the classic HSRs and reactions that do not correspond to this classification [7].