The prophylactic conversion to an extended infusion schedule and use of premedication to prevent hypersensitivity reactions in ovarian cancer patients during carboplatin retreatment Journal Article

   

Authors:	O'cearbhaill, R.; Zhou, Q.; Iasonos, A.; Hensley, M. L.; Tew, W. P.; Aghajanian, C.; Spriggs, D. R.; Lichtman, S. M.; Sabbatini, P. J.
Article Title:	The prophylactic conversion to an extended infusion schedule and use of premedication to prevent hypersensitivity reactions in ovarian cancer patients during carboplatin retreatment
Abstract:	Objective: Repeated exposure to carboplatin can lead to hypersensitivity reactions during retreatment with carboplatin. This may prevent its further use in platinum-sensitive ovarian cancer patients. At our institution, an increasing proportion of patients are prophylactically converted to an extended schedule of infusion after 8 cycles of carboplatin. We sought to determine whether an incrementally increasing, extended 3-hour infusion of carboplatin with appropriate premedication was associated with a lower rate of hypersensitivity reactions compared to the standard 30-minute schedule in sequentially treated patients. Methods: We performed a retrospective electronic medical record review of patients with recurrent ovarian cancer retreated with carboplatin at our institution from January 1998 to December 2008. Results: Seven hundred and seventy-seven patients with relapsed ovarian, fallopian tube, or primary peritoneal cancer were retreated with carboplatin and met study inclusion criteria. Of these, 117 (17%) developed hypersensitivity reactions during second-line or greater carboplatin-based treatment for recurrent disease. Only 6 (3.4%) of the 174 patients who received the extended schedule developed hypersensitivity reactions (0% grade 4; 50% grade 3) compared to 111 (21%) of 533 patients in the standard schedule group (13% grade 4; 77% grade 3). The first hypersensitivity episode occurred after a median of 16 platinum (carboplatin and cisplatin) treatments in the extended group compared to 9 in the standard group. Using the Fisher exact test, there was an association with a reduced incidence of hypersensitivity reactions with the extended infusion schedule (P < 0.001). Conclusion: Our data suggest appropriate premedication and prophylactic conversion to an extended infusion during carboplatin retreatment may reduce hypersensitivity reactions. © 2009 Elsevier Inc. All rights reserved.
Keywords:	adolescent; adult; cancer chemotherapy; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; retrospective studies; young adult; major clinical study; disease course; cisplatin; drug withdrawal; antineoplastic agents; gemcitabine; paclitaxel; cancer patient; recurrent cancer; ovarian cancer; ovarian neoplasms; carboplatin; ovary cancer; peritoneum cancer; peritoneal neoplasms; drug administration schedule; oxygen therapy; dexamethasone; medical record review; retrospective study; docetaxel; drug hypersensitivity; salbutamol; dosage schedule comparison; evening dosage; morning dosage; drug infusion; cancer relapse; hydrocortisone; uterine tube carcinoma; fallopian tube neoplasms; anaphylaxis; infusions, intravenous; hypersensitivity reaction; infusion fluid; diphenhydramine; premedication; ranitidine; adverse drug reactions; peritoneal cancer
Journal Title:	Gynecologic Oncology
Volume:	116
Issue:	3
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2010-03-01
Start Page:	326
End Page:	331
Language:	English
DOI:	10.1016/j.ygyno.2009.10.070
PUBMED:	19944454
PROVIDER:	scopus
PMCID:	PMC4369374
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-75749150453&partnerID=40&md5=e5f36e7235ab30cdffa651d9a9d45fd8
Notes:	--- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: GYNOA" - "Source: Scopus"

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