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First-line carboplatin/nab-paclitaxel in advanced ovarian cancer patients, after hypersensitivity reaction to solvent-based taxanes: a single-institution experience

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Abstract

One of the major challenges related to solvent-based taxanes administration in clinical practice is the high rate of hypersensitivity reactions (HSRs). Nab-paclitaxel is a solvent-free, albumin-bound, paclitaxel, which minimize the risk of HSR occurrence. In this single-institution, retrospective analysis, we evaluated stage IIIc–IV epithelial ovarian cancer (EOC) patients, treated with first-line carboplatin/nab-paclitaxel (± bevacizumab), after the occurrence of an HSR with solvent-based paclitaxel (and/or docetaxel). Between April 2012 and December 2018, ten patients (20.8%) received carboplatin/nab-paclitaxel (± bevacizumab) after the occurrence of an HSR to solvent-based taxanes. Among the evaluable patients, ORR was 100%. At median follow-up of 28.5 months, median PFS was 16.7 months, and median OS was 65.4 months, respectively. Median received dose intensity (DI) was 86% and 80% of the projected DI for nab-paclitaxel and carboplatin, respectively. There were no treatment-related grade 4 adverse events. Most relevant treatment-related grade 3 adverse events were: asthenia (10%), hypertransaminasemia (10%), neutropenia (20%), thrombocytopenia (20%), and anemia (10%). No HSR recurrence was observed. The high rate of HSR occurrence could limit first-line treatment options in clinical practice. Carboplatin/nab-paclitaxel association could represent a valid treatment option in this setting.

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Authors and Affiliations

  1. Medical Oncology, St. Salvatore Hospital, Via Vetoio, 67100, L’Aquila, Italy

    A. Parisi, A. Cortellini, G. Porzio & C. Ficorella

  2. Departement of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy

    A. Parisi, A. Cortellini, T. Sidoni, V. Cocciolone, P. Lanfiuti Baldi, G. Porzio, C. Ficorella & K. Cannita

  3. Gynecologic Oncology Unit, Department of Women and Children Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

    E. Palluzzi

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  1. A. Parisi
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All authors read and approved the manuscript and agree to be accountable for all aspects of the research in ensuring that the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to A. Parisi.

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Conflict of interest

Dr Cortellini received grant as speaker/advisory role/consultancies from: Astrazeneca, MSD, Boehringer Ingelheim, Roche, Istituto Gentili, Ipsen and BMS. All other authors do not have any competing interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local responsible committee (Comitato Etico per le province di L’Aquila e Teramo) and with the 1964 Helsinki declaration and its later amendments. Every patient provided a written informed consent. The study was conducted protecting all the personal data of the respondents. This article does not contain any studies with animals performed by any of the authors.

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Parisi, A., Palluzzi, E., Cortellini, A. et al. First-line carboplatin/nab-paclitaxel in advanced ovarian cancer patients, after hypersensitivity reaction to solvent-based taxanes: a single-institution experience. Clin Transl Oncol 22, 158–162 (2020). https://doi.org/10.1007/s12094-019-02122-x

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  • DOI: https://doi.org/10.1007/s12094-019-02122-x

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