Predictors of immediate and delayed cutaneous hypersensitivity reactions to paclitaxel Journal Article
| Authors: | Trager, M. H.; Kuo, A. M.; Dusza, S. W.; Park, V.; Geskin, L.; Guyer, A.; Abuhadra, N.; Gucalp, A.; Lacouture, M. E. |
| Article Title: | Predictors of immediate and delayed cutaneous hypersensitivity reactions to paclitaxel |
| Abstract: | Paclitaxel is one of the first-line treatments for breast, ovarian, and lung cancers. However, its use is limited by the high frequency of hypersensitivity reactions. In this retrospective chart review at Memorial Sloan Kettering Cancer Center, we assess clinical factors associated with immediate and delayed hypersensitivity reactions to paclitaxel and characterize delayed hypersensitivity reactions to paclitaxel in patients with breast cancer. 12,274 patients were treated with paclitaxel. 6,165 had breast cancer and 1,233 were seen by a dermatologist. 734 patients (11.9%) developed an immediate hypersensitivity reaction. Age (p < 0.001), race (p < 0.001), and prior history of allergy (p = 0.05) were associated with immediate hypersensitivity reactions. 147 patients (4.0%) had a rash of interest. The most common phenotypes were maculopapular (52%) and urticaria (36%). Race (p < 0.001) and history of allergy (p < 0.001) were associated with development of a cutaneous reaction. Patients with an immediate hypersensitivity reaction were more likely to have developed a delayed cutaneous reaction (OR = 1.80). Risk factors for development of immediate hypersensitivity reactions in this study were younger age, race, and history of allergy. Patients who developed an immediate hypersensitivity reaction were more likely to develop a delayed hypersensitivity reaction. Risk factors for development of the rash included Asian race and history of allergy. Identification of risk factors is critical to guide care coordination. Awareness of these clinical factors which are associated with development of a rash could guide providers in choosing treatment with paclitaxel or nab-paclitaxel. If the cutaneous reactions are bothersome to the patient, the transition of treatment from paclitaxel to nab-paclitaxel may be warranted, or a consideration of re-challenge or desensitization may be discussed. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. |
| Keywords: | adult; controlled study; aged; middle aged; retrospective studies; major clinical study; skin manifestation; paclitaxel; cancer patient; antineoplastic agent; phenotype; drug eruption; breast cancer; allergy; antineoplastic agents, phytogenic; risk factors; age factors; breast neoplasms; medical record review; retrospective study; risk factor; age; drug hypersensitivity; rash; maculopapular rash; immunology; breast tumor; diagnosis; epidemiology; drug therapy; hypersensitivity reaction; urticaria; race; drug eruptions; etiology; delayed hypersensitivity; medical history; asian; hypersensitivity, delayed; humans; human; male; female; article; hypersensitivity, immediate; immediate type hypersensitivity |
| Journal Title: | Archives of Dermatological Research |
| Volume: | 316 |
| ISSN: | 0340-3696 |
| Publisher: | Springer |
| Date Published: | 2024-10-09 |
| Start Page: | 665 |
| Language: | English |
| DOI: | 10.1007/s00403-024-03402-5 |
| PUBMED: | 39382584 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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