Options in Hypersensitivity Reactions to Chemotherapeutics
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Purpose of review
Chemotherapeutic drugs still represent a gold standard for the treatment of neoplastic disease. They can induce hypersensitivity reactions and are the third leading cause of fatal drug-induced anaphylaxis in the USA. This article has tried to highlight and summarize the most recent scientific progress concerning risk factors, pathogenesis, diagnosis, and treatment of these reactions.
Identification of patients at high risk of developing hypersensitivity reactions allows risk stratification to guide clinical decision-making. Therefore, the most recent researches evaluated the possibility to perform risk stratification in case of hypersensitivity reactions to platinum compounds and taxanes. In addition, new data are now available regarding the role of in vitro test for the diagnosis of reactions to platins and the role of drug provocation test in case of hypersensitivity to a number of chemotherapeutics. However, actually, the allergological work-up includes a very careful anamnesis of the patient and the characteristics of reaction, whereas skin tests are useful only for few classes of chemotherapy, namely platinum salts and probably taxanes. Premedication, desensitization and, in some cases, skin tests are able to prevent the majority of hypersensitivity reactions, permitting the administration of the most effective therapy.
Clearly, more studies are needed to better understand, diagnose, treat, and prevent these reactions. To reach this aim, a multidisciplinar approach to the cancer patient with potential allergies is needed.
KeywordsChemotherapy hypersensitivity Drug allergy Platinum compound hypersensitivity Taxane hypersensitivity Asparaginase hypersensitivity Desensitization
Compliance with Ethical Standards
Conflict of Interest
Mauro Pagani declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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