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Importance of Diagnostics Prior to Desensitization in New Drug Hypersensitivity: Chemotherapeutics and Biologicals

  • Drug Allergy (C Mayorga, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Abstract

Purpose of review

In this review article, we intend to summarize the diagnostic tools available for the study of drug hypersensitivity reactions to chemotherapy and biologicals, based on the experience and controversies of the main research groups leading the topic.

Recent findings

Recent publications with large cohorts of patients reacting to these drugs are allowing for a better understanding of phenotyping, endotyping, and optimally managing these patients.

Summary

There is a remarkable heterogeneity on the diagnostic and therapeutic approach among the different groups, and yet this has allowed for very interesting discoveries. Clinical history alone is insufficient for a diagnosis, but in vitro and in vivo biomarkers are essential for personalized management plans and precision medicine. Drug provocation testing is an essential tool and criterion standard. Despite heterogeneity, dedicated multidisciplinary drug desensitization program/unit, with dedicated space and personnel for their activities, have shown to be the optimal approach. In this acticle, we provide detailed information on diagnostics tools, with an specific focus on drug provocation testing. Looking forward, collaboration, standardization of techniques, and generalization of solidly established drug allergy teams in large hospitals are fundamental steps for the specialty of allergy in the twenty-first century.

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

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Authors and Affiliations

  1. St Bartholomew’s Hospital, Barts Health NHS Trust, Allergy & Severe Asthma Service, London, UK

    Ricardo Madrigal-Burgaleta MD, PhD & F. R. Ali MBBS, PhD

  2. Programa de Dessensibilització ICO-HUB, Unitat d’Al·lergologia, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain

    P. Vazquez-Revuelta MD, J. Marti-Garrido MD & R. Lleonart MD

  3. Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain

    Emilio Alvarez-Cuesta MD, PhD

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  1. Ricardo Madrigal-Burgaleta MD, PhD
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Correspondence to Ricardo Madrigal-Burgaleta MD, PhD.

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Ricardo Madrigal-Burgaleta, Paula Vazquez-Revuelta, Jaume Marti-Garrido, Ramon Lleonart, Runa Ali, and Emilio Alvarez-Cuesta declare no conflicts of interest relevant to this manuscript.

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Madrigal-Burgaleta, R., Vazquez-Revuelta, P., Marti-Garrido, J. et al. Importance of Diagnostics Prior to Desensitization in New Drug Hypersensitivity: Chemotherapeutics and Biologicals. Curr Treat Options Allergy 7, 1–13 (2020). https://doi.org/10.1007/s40521-020-00238-y

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