Severe hypersensitivity reactions to platinum compounds post-pressurized intraperitoneal aerosol chemotherapy (PIPAC): first literature report
Pressurized intraperitoneal aerosol chemotherapy (PIPAC) shows encouraging results for patients with unresectable peritoneal metastasis. Several reports demonstrated the safety of the procedure combined with systemic chemotherapy, with a low rate of complication. The aim of this study is to report severe hypersensitivity reactions to platinum compounds (SHRPC) during PIPAC procedures.
All patients who underwent PIPAC for non-resectable PC in Lyon Sud University hospital were included in a prospective institutional database. All patients who presented a SHRPC after PIPAC were included in our analysis.
One hundred and thirty-two patients underwent 383 PIPAC procedures between December 2015 and December 2017. oxaliplatin’s and cisplatin–doxorubicin’s protocols were used in 71 and 312 PIPAC, respectively. Four patients (3%) developed SHRPC; two patients (2.8%) after oxaliplatin and two patients (0.6%) after cisplatin–doxorubicin protocols. SHRPC occurred during the 6th PIPAC with cisplatin–doxorubicin protocol and during 2nd and 3rd PIPAC of the oxaliplatin protocol. Three events appeared within 15 min and one event occurred 50 min following nebulization. All the SHRPC have been managed successfully without any complication.
This is the first report of SHRPC after PIPAC. The physician must constantly keep this rare but life-threatening complication in mind, especially after repeated PIPAC administration or previous platinum-based systemic chemotherapy.
KeywordsPeritoneal metastasis Cisplatin Doxorubicin Oxaliplatin HIPEC Allergy SHRPC
This study was not funded.
Compliance with ethical standards
Conflict of interest
Matthieu Siebert, Mohammad Alyami, Frederic Mercier, Colin Gallice, Laurent Villeneuve, Frédéric Bérard, Olivier Glehen, Naoual Bakrin, and Vahan Kepenekian have no conflicts of interest or financial ties to disclose.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 5.Baratti D et al (2013) Diffuse malignant peritoneal mesothelioma: long-term survival with complete cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). Eur J Cancer Oxf Engl 1990 49:3140–3148Google Scholar
- 22.Société française d’anesthésie réanimation (2010) Prise en charge d’un choc anaphylactique. https://sfar.org/wp-content/uploads/2015/07/Choc_Anaphylactique_SFAR_2010.pdf
- 33.Andre : Andre T, Boni C, Mounedji-Boudiaf L et al (2004) Adjuvant chemotherapy with oxaliplatin, in combination with fluorouracil plus leucovorin prolongs disease-free survival, but causes more adverse events in people with stage II or III colon cancer Abstracted from. Multicenter international study of oxaliplatin/5-fluorouracil/leucovorin in the adjuvant treatment of colon cancer (MOSAIC) investigators. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343–2351. Cancer Treat Rev 30:711–713CrossRefGoogle Scholar