Retrospective study of hypersensitivity reactions to chemotherapeutic agents in a thoracic oncology service
| Autor: | Céline Tummino, Marion Gouitaa, Fabrice Barlesi, H. Capelle, Marc Montana, L. Greillier, Joëlle Birnbaum, N. Ausias |
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| Přispěvatelé: | Assistance Publique - Hôpitaux de Marseille (APHM), Oncologie multidisciplinaire et innovations thérapeutiques [Hôpital Nord - APHM], Aix Marseille Université (AMU)- Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM), Service de dermatologie, vénéreologie et cancérologie cutanée [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Institut de Chimie Radicalaire (ICR), Aix Marseille Université (AMU)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE) |
| Rok vydání: | 2017 |
| Předmět: |
Mesothelioma
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Population Antineoplastic Agents Platinum Compounds Pemetrexed Cross Reactions Drug Hypersensitivity 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Carcinoma Non-Small-Cell Lung medicine [CHIM]Chemical Sciences Humans Pharmacology (medical) education Lung cancer Adverse effect Retrospective Studies Skin Tests Pharmacology Chemotherapy education.field_of_study business.industry Mesothelioma Malignant Reproducibility of Results medicine.disease Dermatology 3. Good health Surgery Hypersensitivity reaction Negative Skin Test 030220 oncology & carcinogenesis business Anaphylaxis medicine.drug |
| Zdroj: | Journal of Clinical Pharmacy and Therapeutics Journal of Clinical Pharmacy and Therapeutics, 2018, 43 (3), pp.320--326. ⟨10.1111/jcpt.12645⟩ |
| ISSN: | 1365-2710 0269-4727 |
| Popis: | WOS:000431653900002; What is known and objective: With the increasing use of cancer chemotherapy agents, hypersensitivity reactions are commonly encountered. The allergic clinical symptoms are variable and unpredictable. The aim of this study was to identify the characteristics of hypersensitivity reactions and to assess the value of skin tests for platinum salts and pemetrexed in the treatment of patients with non-small cell lung cancers or malignant pleural mesothelioma. Methods: A single-centre retrospective study was performed for 2 years. Patients treated with the drugs of interest for an advanced or metastatic non-small cell lung cancers or malignant pleural mesothelioma and who experienced hypersensitivity reactions symptoms were eligible for this study. Clinical symptoms of hypersensitivity reactions, population characteristics and administered chemotherapy regimens were identified. Results: The hypersensitivity reactions frequency was rare (1.2%) and concerned 17 patient s in our study. Typical clinical features of immediate hypersensitivity reactions associated with treatment were observed for nine patients (anaphylactic reactions for three cases, angioedema and hypotension associated with asthenia and heat in one case, respectively, and other cutaneous symptoms in the remaining four cases). Skin tests were positive in three patients, but only for platinum salts. The outcome after reintroduction of a negatively tested platinum salt allowed us to calculate a negative predictive value for platinum salt skin tests of 100%. For pemetrexed, skin tests were negative for all patients. What is new and conclusion: Skin tests could be used to diagnose hypersensitivity reactions with platinum salts or to evaluate the possibility of cross-reactions between two platinum salts. A negative skin test may predict with reasonable reliability the absence of future hypersensitivity reactions in case of reintroduction of drug infusion. Because the IgE-mediated mechani sm has never been demonstrated for pemetrexed, skin tests are not valid and have no diagnostic value for this molecule. Because hypersensitivity reactions are potentially fatal adverse events, we recommend that patients who experience a hypersensitivity reactions onset should be monitored closely and clinicians must be aware of hypersensitivity reaction signs. |
| Databáze: | OpenAIRE |
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