Value of Skin Tests for Managing Hypersensitivity Reactions to Platinum Salts

Abstract

Background: Platinum-based therapy continues to be one of the pillars of the treatment of different types of cancer. However, many times the responsible clinician renounces its use after the appearance of a hypersensitivity reaction.Objective: To assess the value of skin tests (ST) in clinical practice to address the treatment of patients with suspicion of immediate hypersensitivity reactions (HSRs) to platinum salts.Methods: Single-center retrospective study performed for 3 years. Adult patients treated with any platinum salt who experienced HSR symptoms and for whom an oncologist requested ST, were included. ST with cisplatin, carboplatin and oxaliplatin were performed. Results: Twenty-two patients were included. ST were positive in 12 patients (54.5%), of which 4 (33%) presented cross-reactivity to another platinum salt. Fifteen patients continued platinum-based chemotherapy: 9 patients with positive ST (4 continued by desensitization and 5 with another platinum) and 6 patients with negative ST, of which 1 repeated an HSR. A NPV of 0.91 was calculated. Conclusion: ST allowed accurate identification of platinum allergy patients and the resumption of platinum-based therapy in many patients for whom no suitable therapeutic alternative was clinically acceptable.