esmo 2017 hypersensitivity

PDF Management of Immune-related Adverse Events in Patients Treated - Asco Evaluation of the incidence of carboplatin hypersensitivity in cancer patients. doi: 10.1093/annonc/mdy158. The rate of hypersensitivity was significantly higher among patients with advanced stage disease (IIIIV) compared to patients with early stage disease (III) (P < 0.001, Kruskal-Wallis test), and among patients with serous or mixed histological type compared to patients with other histological types (P = 0.003, Kruskal-Wallis test). Necessary cookies enable core functionality. These ESMO Clinical Practice Guidelines provide recommendations on the prevention/management of dermatological toxicities. government site. Cancer 20, 385393. The incidence of carboplatin-related hypersensitivity correlated with cycle number and dose, with the first episode occurring at a median of 12 cycles and 6,816 mg. Anticancer. An official website of the United States government. 105, 8183. | DOI: 10.1097/HS9.0000000000000695. Management of infusion reactions to systemic anticancer therapy: ESMO As shown in Table 6, drug or food history (odd ratios [OR] 2.340, 95% confidence interval [CI] 1.374-3.984, P = 0.0018), malignant ascites (OR 1.895, 95% CI 1.1083.241, P = 0.0196), and cumulative carboplatin dose (4,0004,999 mg: OR 5.507, 95% CI 1.79616.887, P = 0.0028; 5,0009,999 mg: OR 7.244, 95% CI 2.74019.149, P < 0.0001; 10,000 mg: OR 8.461, 95% CI 3.00723.806, P < 0.0001; P for trend < 0.0001) significantly positively correlated with carboplatin hypersensitivity. A cumulative carboplatin dose >4,000 mg significantly positively correlated with carboplatin hypersensitivity. Cisplatinum rechallenge in relapsed ovarian cancer patients with platinum reinduction therapy and carboplatin hypersensitivity. For more detailed information on the cookies we use, please check our Privacy Policy. Drug Interactions in the Treatment of Malignancy in HIV-Infected Patients. 2017 Jul 1;28(suppl_4):iv119-iv142. Atopic patients are at increased risk for chemotherapy and MoAbs drug allergy and the current patterns of treatment with recurrent and intermittent drug exposures may favor the development of drug allergies. Necessary cookies enable core functionality. Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly. Among the 651 women (88.6%) diagnosed with ovarian cancer, 474 (64.5%) had stage IIIIV disease. (2005). Care. J. Gynecol. 31, 45254528. Study conception and design: Y-HT and W-FC. These scores have been defined by the guideline authors and validated by the ESMO Translational Research and Precision Medicine Working Group.17 g Selpercatinib is EMA approved for treating adults with advanced or metastatic RET fusion-positive TC who had already received lenvatinib or sorafenib. For more detailed information on the cookies we use, please check our Privacy Policy. J Investig Allergol Clin Immunol. However, other studies have reported severe hypersensitivity reactions to cisplatin in patients with prior carboplatin hypersensitivity reactions (Zweizig et al., 1994; Dizon et al., 2002). BRCA1/2 mutation has been reported to correlate with carboplatin hypersensitivity (Altwerger et al., 2017). 105, 14721479. de Las Vecillas Snchez L, Alenazy LA, Garcia-Neuer M, Castells MC. Blood. doi: 10.1111/j.1525-1438.2005.00136.x, Koshiba, H., Hosokawa, K., Kubo, A., Miyagi, Y., Oda, T., Miyagi, Y., et al. Oncol. This patient developed hypersensitivity reactions during her 23rd cycle of carboplatin administration at a cumulative dose of approximately 14,000 mg. She experienced skin rash, tachycardia, and dyspnea 13 min after starting the infusion. (2003). Via Ginevra 4, 6900 Lugano - CH Copyright 2023 European Society for Medical Oncology All rights reserved worldwide. Oncol. A. Oncol. (2009). Int. (2005). 2023 Mar 15;210(6):709-720. doi: 10.4049/jimmunol.2100485. Model of in vitro mouse mast cells activation and desensitization. The https:// ensures that you are connecting to the J. Gynecol. 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Management of infusion reactions to systemic anticancer therapy: ESMO Incidence and intensity of anaphylaxis/hypersensitivity events: Table: 138P. Paclitaxel plus platinum-based chemotherapy vs. conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. We analyzed the relationships among the incidence, characteristics, risk factors, management, and outcomes of carboplatin-related hypersensitivity reactions in this patient population. Cisplatin administration following carboplatin desensitization failure in primary peritoneal cancer: a brief report. 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J. Clin. Compared to those without hypersensitivity reactions, women who experienced hypersensitivity reactions had a significantly higher median number of cycles (12 vs. 6, P < 0.001, independent sample t-test) and dose (6,816 vs. 3,844 mg, P < 0.001, independent sample t-test, Table 3). 2019 Nov;15(11):e925-e933. -, Sakaeda T, Kadoyama K, Yabuuchi H, Niijima S, Seki K, Shiraishi Y, et al. II., Markman, M., Brown, J., et al. Clinical analysis of thirteen cases of hypersensitivity reactions to carboplatin. Hypersensitivity reactions are generally unexpected, regulated by the immune system, and allergic in nature. Gynecol. PMC E. Restuccia: Financial Interests, Personal, Full or part-time Employment: F. Hoffmann-La Roche Ltd.; Financial Interests, Personal, Stocks/Shares: Genentech, Inc; Non-Financial Interests, Personal, Research Grant, Medical writing support: F. Hoffmann-La Roche Ltd. S. 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Hoffmann-La Roche Ltd.; Financial Interests, Institutional, Advisory Board: MSD. 329 (152 CPI-treated v 177 CPI-nave, including 60 tx-nave) pts with RET fusion+ NSCLC were analyzed. Would you like email updates of new search results? (2013). The .gov means its official. Unauthorized use of these marks is strictly prohibited. Although infusion reactions can be allergic or non-immune-mediated, the clinical manifestations are the same and require prompt assessment and appropriate intervention. Abstracts, slide sets and webcasts from ESMO 2017 Congress are now available. (2016). Zhonghua. Login to your ESMO account to sign up for ESMO newsletters and receive information about ESMO's scientific and educational resources, events, member benefits. (2013). A., Colombo, N., du Bois, A., Delaloye, J. F., Kristensen, G. B., et al. 2014;24(2):72-9; quiz 2 p following 79. By delivering the target dose of the drug by small incremental doubling doses (Figure 3), the threshold for anaphylaxis is re-established at each step and never reaches that of the initial triggering dose. Authorship includes a multidisciplinary group of experts from different institutions and countries in Europe and abroad. The results of the trial could answer whether carboplatin hypersensitivity patients have similar chemo-responses in non-platinum regimens without compromising the efficacy of the antineoplastic regimens of these patients. This site uses cookies. Thus, we chose the cumulative carboplatin dose for the analysis to avoid interference between the highly correlated factors. Gender, age, ethnicity and race were similar between subgroups as were objective response rates (ORR) (64% CPI-treated v 62% CPI-nave). With a lower carboplatin infusion rate and pre-treatment with anti-allergy drugs, all of these patients were able to tolerate re-treatment with carboplatin, although 48 (78.7%) of these 61 patients developed hypersensitivity again despite the desensitization protocol. Cancer. J. Clin. The comparison between other countries and ours about characteristics of the patients receiving carboplatin-based chemotherapy and risk factors of carboplatin-related hypersensitivity reactions. 24, 46994707. Shah et al. All funding for this site is provided directly by ESMO. Multivariate analysis was conducted using logistic regression to estimate the association between the potential risk factors and the occurrence of hypersensitivity. J. Gynecol. (2009) reported the successful re-treatment of the majority of patients with previous carboplatin-related hypersensitivity reactions. Altwerger et al. Our findings also suggest that a history of drug or food allergies is a predictive factor for carboplatin-related hypersensitivity. Int. 103, 608613. Disclaimer. Oncology 61, 129133. Author Information. Information for media including press accreditation. All funding for this site is provided directly by ESMO. All of these reported symptoms and signs occurred within an hour of initiating carboplatin administration. Gynecol. Int J Med Sci (2011) 8(4):3328.10.7150/ijms.8.332 DARMSTADT, Germany, August 31, 2017 /PRNewswire/ --Not intended for U.K. or U.S. based media ESMO 2017 abstract #Erbitux: 576P, 593P, 1068P, 1579. Gynecol. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used. The cumulative incidence of carboplatin-related hypersensitivity was 2% after 8 cycles, 6% after 14 cycles, 8% after 19 cycles, and 10% after 33 cycles, with a plateau beyond this cycle number (Figure 1A). This was the largest series of gynecological malignancies investigated for carboplatin-related hypersensitivity reactions. The scale uses a rational, structured and consistent approach to derive a relative ranking of the magnitude of clinically meaningful benefit that can be expected from anti-cancer treatments.ESMO-MCBS scores are included in ESMO Clinical Practice Guidelines to help further guide treatment decisions. PDF | On Jul 1, 2017, J B A G Haanen and others published Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up | Find, read and . LBA10004 The full, final text of this abstract will be available at abstracts.asco.org at 2:00 PM (EDT) on Friday, June 2, 2017, and in the Annual Meeting Proceedings online supplement to the June . and transmitted securely. Clinical practice guidance in a modernised format that focuses on visual representation of recommendations for quick and easy reference by practicing clinicians. Gynecol. The essential content of the guidelinesin condensed slide format in PDF or PowerPoint. Successful carboplatin desensitization in patients with proven carboplatin allergy. Furthermore, Moon et al. 1; Mandac Smoljanovi, Inga 2. (Bruchim et al., 2014) demonstrated safe re-treatment with carboplatin using a desensitization protocol to reduce repeated hypersensitivity reactions, and Koshiba et al. Merck KGaA, Darmstadt, Germany: Driving Innovation in Cancer Care at Federal government websites often end in .gov or .mil. Among cases developing carboplatin-related hypersensitivity reactions, the median number of cycles is 912, and the median doses 6,0008,000 mg. Reported risk factors for carboplatin-related hypersensitivity reactions include carboplatin cycle/dose, platinum-free interval, and history of drug allergies (Libra et al., 2003; Confino-Cohen et al., 2005; Schwartz et al., 2007; Koshiba et al., 2009). Carboplatin is among the most commonly used chemotherapeutic agents for ovarian, fallopian tube, and primary peritoneal cancer, as it is active against these types of cancers with usually well-tolerated side effects (Ozols et al., 2003; Parmar et al., 2003; Pfisterer et al., 2006; Pujade-Lauraine et al., 2010). Severe carboplatin-related hypersensitivity reactions are uncommon. Type II hypersensitivity is an IgG or IgM antibody-dependent cytotoxicity in which an antigen attached to cell membranes of red blood cells or platelets binds to an antibody, leading to cell or tissue damage such as haemolytic anaemia or thrombocytopenia. A sincere thanks to the almost 24,000 participants who attended this year's annual congress! doi: 10.1006/gyno.1994.1098, Keywords: ovarian cancer, chemotherapy, carboplatin, hypersensitivity, risk factor, Citation: Tai Y-H, Tai Y-J, Hsu H-C, Lee S-P, Chen Y-Y, Chiang Y-C, Chen Y-L, Chen C-A and Cheng W-F (2017) Risk Factors of Hypersensitivity to Carboplatin in Patients with Gynecologic Malignancies. Login to your ESMO account to sign up for ESMO newsletters and receive information about ESMO's scientific and educational resources, events, member benefits. Classical and new chemotherapy drugs, monoclonal antibodies (MoAbs), and small molecules to treat cancer and chronic inflammatory diseases are aimed at improving quality of life and life expectancy of patients, but an increasing number of reactions including anaphylaxis precludes their use in targeted populations. 57, 163167. In our study, 36% of the patients with carboplatin-related hypersensitivity reactions had a history of drug allergies. The site is secure. (Moon et al., 2013) BRCA1/2 mutation patients had early-onset carboplatin hypersensitivity at a lower cumulative exposure. Characteristics of the 735 women receiving carboplatin-based chemotherapy. (PDF) Management of cancer pain in adult patients: ESMO Clinical Therefore, disease severity, histological type, malignant ascites, past drug allergies, and cumulative carboplatin dose are risk factors for carboplatin-related hypersensitivity reactions. Recommendations for prevention/therapy of acneiform rash, hand-foot syndrome, alopecia, pruritus, paronychia and onycholysis are provided including levels of evidence and grades of recommendation where applicable. 2022 Oct 18;12:994155. doi: 10.3389/fonc.2022.994155. A three-step method was developed to identify hypersensitivity reactions, including anaphylaxis, in a clinical trial database and could be applied to investigational drugs to improve early detection and monitoring of potential safety concerns, subsequent patient safety management strategies, and potentially programme-wide drug development It would be worthwhile to design a perspective trial that could randomize patients with carboplatin hypersensitivity to receive an alternative regimen without carboplatin. Similarly, a Japanese study found that carboplatin hypersensitivity occurred at a median of 11.5 cycles and 8,084.5 mg (Koshiba et al., 2009). ESMO Clinical Practice Guidelines for Surveillance of Hereditary Does the platinum-free interval predict the incidence or severity of hypersensitivity reactions to carboplatin? In the majority of ovarian cancer cases, primary management entails surgical staging or cytoreduction, followed by systemic chemotherapy (Ledermann et al., 2013). The incidence of carboplatin-related hypersensitivity was higher in patients with advanced stage disease (P < 0.001, Kruskal-Wallis test), serous and mixed histological types (P = 0.003, Kruskal-Wallis test), malignant ascites (P = 0.009, chi-square test), and history of other drug allergy (P < 0.001, chi-square test). 8:800. doi: 10.3389/fphar.2017.00800. Infusion reactions to systemic chemotherapy - UpToDate Chan. The cumulative incidence of carboplatin-related hypersensitivity reactions increased with the number of carboplatin cycles (Figure 1A) and increasing dose (Figure 1B), especially at >8 cycles or a dose >3,500 mg. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. The cumulative incidence of severe carboplatin-related hypersensitivity was 1% after 15 cycles and 2% after 24 cycles, with a plateau beyond this cycle number, and 1% at >7,500 mg and 2% at >12,500 mg, with a plateau beyond this dose (Figures 1A,B). Patients without ovarian cancer were excluded from retrospective analysis of details of hypersensitivity reactions recorded contemperaneously between April 2019 - January 2020 on excel and chemocare (CIS Oncology, Belfast, UK) by the treating practitioner. Oncol. 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Assess for lymphadenopathy, facial or distal extremity swelling (may be signs of drug-induced hypersensitivity syndrome/DRESS). doi: 10.1007/s10147-014-0731-1. Drafting of manuscript: Y-HT and W-FC. Carriers of BRCA genes develop drug allergy after fewer exposures and can present with severe reactions, including anaphylaxis. MeSH MINIMAL Requirements:Google Chrome 24+,Mozilla Firefox 20+,Internet Explorer 11,Opera 1518,Apple Safari 7,SeaMonkey 2.15-2.23. Most events occurred during chemotherapy. A., Raja, F. A., Fotopoulou, C., Gonzalez-Martin, A., Colombo, N., Sessa, C., et al. doi: 10.1200/JCO.1999.17.4.1141, Moon, D. H., Lee, J. M., Noonan, A. M., Annunziata, C. M., Minasian, L., Houston, N., et al. Clinical Practice Guidelines on Supportive Care - ESMO There is evidence that inhibitory mechanisms blocking IgE/antigen mast cell activation are active during desensitization, enhancing safety. Necessary cookies enable core functionality. doi: 10.1016/j.ygyno.2006.04.002, Ozols, R. F., Bundy, B. N., Greer, B. E., Fowler, J. M., Clarke-Pearson, D., Burger, R. A., et al. Among these 75 women, 16 (21.3%) experienced severe hypersensitivity reactions (grades 3 and 4). This site needs JavaScript to work properly. doi: 10.1016/S0140-6736(03)13718-X, Pfisterer, J., Plante, M., Vergote, I., du Bois, A., Hirte, H., Lacave, A. J., et al. Cancer 109, 10721078. Before Table 5 reports the incidences of carboplatin hypersensitivity and patient characteristics reported in various investigations, including the present study. Request PDF | On Jul 13, 2017, Susana Rosell Kernen published Management of infusion reactions to systemic anticancer therapy: ESMO Clinical Practice Guidelines | Find, read and cite all the . We evaluated the prevalence of and risk factors for hypersensitivity reactions related to carboplatin, which is commonly used to treat gynecological malignancies. Analysis of the pattern of hypersensitivity reactions in patients receiving carboplatin retreatment for recurrent ovarian cancer. 66, 730. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: An intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. News, highlights and insights download your copy here. ESMO Virtual Congress 2020 | OncologyPRO ESMO Call to Action on COVID-19 Vaccinations and Patients with Cancer: Vaccinate. The overall safety profile was similar between subgroups. Oncol. Monitor. Hypersensitivity to antineoplastic agents. Most anticancer treatments carry a risk for infusion reactions which incidence may increase when different agents are administered concomitantly. B., Phillips, P. C., Kang, T. I., et al. The ESMO Clinical Practice Guidelines, prepared and reviewed by leading experts and based on the findings of evidence-based medicine, provide you with a set of recommendations to help patients with the best care options. 20, 566573. Bookshelf Nektaria M, Ekaterini S, Ioannis K, Leonidas M, Muhammad Wasif S. Hypersensitivity reactions associated with platinum antineoplastic agents: a systematic review. Life expectancy for cancer patients allergic and desensitized to carboplatin and non-allergic to carboplatin [from Sloane et al. Efficacy and Adverse Events of Carboplatin Desensitisation Therapy for Gynaecological Cancer: A Retrospective Study. Pediatric. 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