A randomized trial of prophylactic extended carboplatin infusion to reduce hypersensitivity reactions in recurrent ovarian cancer Journal Article


Authors: LaVigne, K.; Hyman, D. M.; Zhou, Q. C.; Iasonos, A.; Tew, W. P.; Aghajanian, C.; Makker, V.; Hensley, M. L.; Konner, J.; Grisham, R. N.; Cangemi, N.; Soldan, K.; Spriggs, D. R.; Sabbatini, P. J.; O'Cearbhaill, R. E.
Article Title: A randomized trial of prophylactic extended carboplatin infusion to reduce hypersensitivity reactions in recurrent ovarian cancer
Abstract: Objective Hypersensitivity with repeated exposure to platinum agents is common and can preclude continued treatment, even in patients with disease that remains platinum sensitive. We sought to compare the effects of prophylactic, extended carboplatin infusion versus standard infusion on the rate of carboplatin hypersensitivity reactions (HSRs) in women with recurrent ovarian cancer. Methods This was a single-institution, randomized, nonblinded trial comparing a graded, 3-hour extended infusion of carboplatin with a standard 30-minute infusion in patients with recurrent ovarian cancer who were enrolled from January 2011 to April 2015. The study was designed to detect a decrease in the HSR rate from 20% (standard infusion) to 5% (extended infusion) assuming a type 1 error of 10% and power of 80% using a 1-sided test. Results Of 146 enrolled patients, 114 were evaluable. Fifteen (13%) had an HSR - 11% (6/56) in the extended-infusion and 16% (9/58) in the standard-infusion groups (P = 0.582). Planned treatment completion was achieved in 50 (89%) of 56 patients and 49 (84%) of 58 patients, respectively. Of 25 patients who received single-agent carboplatin, 8 (32%) had an HSR (53% of all patients who had an HSR [8/15]). Of 23 patients who received carboplatin with gemcitabine, 4 (17%) had an HSR (27% of all patients who had an HSR [4/15]). Of 8 patients who received carboplatin with paclitaxel, 3 (38%) had an HSR (20% of all patients who had an HSR [3/15]). There were no HSRs with pegylated liposomal doxorubicin, the most commonly given concurrent chemotherapy (46% of all patients). Conclusions A prophylactic, extended carboplatin infusion was not associated with a decreased HSR rate. The overall low HSR rate suggests that premedication may help reduce HSRs. © 2018 Lippincott Williams and Wilkins. All rights reserved.
Keywords: ovarian cancer; carboplatin; hypersensitivity; hypersensitivity reactions; extended infusion
Journal Title: International Journal of Gynecological Cancer
Volume: 28
Issue: 6
ISSN: 1048-891X
Publisher: Lippincott Williams & Wilkins  
Date Published: 2018-07-01
Start Page: 1176
End Page: 1182
Language: English
DOI: 10.1097/igc.0000000000001280
PROVIDER: scopus
PMCID: PMC6033627
PUBMED: 29757876
DOI/URL:
Notes: Article -- Export Date: 1 August 2018 -- Source: Scopus
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MSK Authors
  1. Vicky Makker
    263 Makker
  2. Jason Konner
    155 Konner
  3. Paul J Sabbatini
    262 Sabbatini
  4. Qin Zhou
    253 Zhou
  5. Alexia Elia Iasonos
    362 Iasonos
  6. Rachel Nicole Grisham
    169 Grisham
  7. Martee L Hensley
    289 Hensley
  8. David Hyman
    354 Hyman
  9. William P Tew
    244 Tew
  10. David R Spriggs
    325 Spriggs
  11. Katherine Anne Lavigne
    11 Lavigne
  12. Nicholas A Cangemi
    10 Cangemi
  13. Krysten Nicole Soldan
    10 Soldan