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Comparison of subsequent infusion hypersensitivity reactions to paclitaxel using two different infusion strategies

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Abstract

Purpose

The purpose of this study was to compare the incidence of rescue medication utilization with up to 3 subsequent doses of paclitaxel in patients who underwent an infusion rate escalation versus those who continued on the standard infusion rate after experiencing an initial paclitaxel infusion hypersensitivity reaction (HSR) requiring rescue medications.

Methods

A retrospective, single-center review was conducted on patients who experienced a paclitaxel infusion HSR requiring rescue medications to their first or second lifetime dose of paclitaxel.

Results

A total of 99 patients were included for analysis, and from this group, 22 patients were continued on the standard infusion rate, while 77 patients were changed to an infusion rate escalation. The rate of subsequent rescue medication utilization was 5% in patients who were continued at the standard infusion rate versus 23% in patients who were changed to an infusion rate escalation (p = 0.064). The incidence of subsequent rescue medication utilization was unrelated to disease stage (p = 0.39), the paclitaxel dosing regimen (p = 0.99), or a diagnosis of asthma (p = 0.99).

Conclusion

This single-center, retrospective study suggests that while not statistically significant, there was a potentially clinically meaningful increase in the rate of subsequent rescue medication utilization in patients who were changed to an infusion rate escalation compared to those who continued on the same standard infusion rate after experiencing an initial HSR to paclitaxel.

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Data availability

All data was collected and managed using the secure software REDCap, behind the OSUWMC firewall. All patient identifiers were removed and coded data was saved in an Excel spreadsheet.

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Authors and Affiliations

  1. Department of Pharmacy, The Arthur G. James Cancer Hospital and Richard J. Solove Institute at The Ohio State University, 460 W 10th Avenue, C150, Columbus, OH, 43210, USA

    Kristen Nymberg, Stephanie Folan, Michael Berger & Craig Vargo

  2. The Ohio State University College of Pharmacy, 500 West 12h Avenue, 214A Parks Hall, Columbus, OH, 43210, USA

    Junan Li & Kyle Zanath

  3. Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Stefanie Spielman Comprehensive Breast Center, 1145 Olentangy River Road, Columbus, OH, 43212, USA

    Jeffrey VanDeusen

Authors
  1. Kristen Nymberg
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  2. Stephanie Folan
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  3. Michael Berger
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  4. Junan Li
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  5. Kyle Zanath
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  6. Jeffrey VanDeusen
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  7. Craig Vargo
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Contributions

Principal investigator: Craig Vargo. Co-investigators: Kristen Nymberg, Michael Berger, Stephanie Folan, Jeffrey VanDeusen, Kyle Zanath, and Junan Li.

Corresponding author

Correspondence to Kristen Nymberg.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study received approval by The Ohio State University Institutional Review Board.

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Nymberg, K., Folan, S., Berger, M. et al. Comparison of subsequent infusion hypersensitivity reactions to paclitaxel using two different infusion strategies. Support Care Cancer 29, 4423–4429 (2021). https://doi.org/10.1007/s00520-021-05991-7

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  • DOI: https://doi.org/10.1007/s00520-021-05991-7

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