Cancer Immunology, Immunotherapy

, Volume 61, Issue 9, pp 1575–1584

Hypersensitivity to antineoplastic agents: mechanisms and treatment with rapid desensitization

  • Mariana Castells
  • Maria del Carmen Sancho-Serra
  • Maria Simarro
Symposium-in-writing paper

DOI: 10.1007/s00262-012-1273-x

Cite this article as:
Castells, M., Sancho-Serra, M..C. & Simarro, M. Cancer Immunol Immunother (2012) 61: 1575. doi:10.1007/s00262-012-1273-x

Abstract

Hypersensitivity reactions (HSRs) to chemotherapy drugs, such as taxanes and platins, and to monoclonal antibodies limit their therapeutic use due to the severity of some reactions and the fear of inducing a potentially lethal reaction in highly sensitized patients. Patients who experience hypersensitivity reactions face the prospect of abandoning first-line treatment and switching to a second-line, less effective therapy. Some of these reactions are mast cell-mediated hypersensitivity reactions, a subset of which occur through an immunoglobulin (IgE)-dependent mechanism, and are thus true allergies. Others involve mast cells without a demonstrable IgE mechanism. Whether basophils can participate in these reactions has not been demonstrated. Rapid drug desensitization (RDD) is a procedure that induces temporary tolerance to a drug, allowing a medication allergic patient to receive the optimal agent for his or her disease. Through RDD, patients with IgE and non-IgE HSRs can safely be administered important medications while minimizing or completely inhibiting adverse reactions. Due to the clinical expansion and success of RDD, the molecular mechanisms inducing the temporary tolerization have been investigated and are partially understood, allowing for safer and more effective protocols. This article reviews the current literature on molecular mechanisms of RDD with an emphasis in our recent contributions to this field as well as the indications, methods and outcomes of RDD for taxanes, platins, and monoclonal antibodies.

Keywords

DesensitizationHypersensitivity reactionsChemotherapy drugsMonoclonalsAllergoOncology Symposium in Writing

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Mariana Castells
    • 1
  • Maria del Carmen Sancho-Serra
    • 1
  • Maria Simarro
    • 2
    • 3
  1. 1.Division of Rheumatology, Immunology and Allergy, Department of MedicineBrigham and Women’s Hospital-Harvard Medical SchoolBostonUSA
  2. 2.Unidad de InvestigaciónHospital Clinico Universitario de ValladolidValladolidSpain
  3. 3.Departamento de Microbiología, Facultad de Medicina de ValladolidValladolidSpain