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Drug Desensitizations for Chemotherapy: Safety and Efficacy in Preventing Anaphylaxis

  • Anaphylaxis and Drug Allergy (BT Kelly and M Castells, Section Editors)
  • Published:
Current Allergy and Asthma Reports Aims and scope Submit manuscript

Abstract

Hypersensitivity reactions (HSRs) to antineoplastic drugs are increasing due to the expanding use of classical and new drugs in a wide variety of malignancies.

Purpose of Review

The goal of this review is to provide current best practices in the diagnosis and management of HSRs based on data and evidence.

Recent Findings

A plethora of studies have provided evidence of the safety and efficacy of rapid drug desensitizations (RDD) to allow for the reintroduction of antineoplastic drugs following an HSR, based on risk stratification. Recently described biomarkers such as basophil activation test, total IgE, BRCA genotyping, and serum IL-6 can aid in guiding improved precision desensitization protocols. Personalized premedication regimens and protocols have improved RDD safety and outcomes.

Summary

RDD allows for the continued use of chemotherapeutic drugs without impaired drug efficacy. RDD represents the best approach to maintain cancer patients on their most effective treatments.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Immunoallergology Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Av. Professor Egas Moniz, 1649-035, Lisbon, Portugal

    Joana Caiado

  2. Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal

    Joana Caiado

  3. Division of Allergy and Immunology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Mariana C. Castells

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Caiado, J., Castells, M.C. Drug Desensitizations for Chemotherapy: Safety and Efficacy in Preventing Anaphylaxis. Curr Allergy Asthma Rep 21, 37 (2021). https://doi.org/10.1007/s11882-021-01014-x

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