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05. Miscellaneous
1095 Management of paclitaxel associated hypersensitivity reactions in gynecological cancers: a single center retrospective analysis
  1. Maria Vittoria Carbone1,
  2. Vanda Salutari2,
  3. Viola Ghizzoni1,
  4. Elena Giudice3,
  5. Maria Chiara Cannizzaro4,
  6. Sara Lardino5,
  7. Lucia Musacchio6,
  8. Floriana Camarda6,
  9. Caterina Ricci1,
  10. Alessandro Petrecca7,
  11. Mariagrazia Distefano8,
  12. Miriam Grazia Ferrara9,
  13. Camilla Nero6,
  14. Gabriella Ferrandina10,
  15. Giacomo Corrado11,
  16. Eleonora Palluzzi11,
  17. Giovanni Scambia11 and
  18. Domenica Lorusso6
  1. 1Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
  2. 2Oncological and Oral Sciences, Rome, Italy
  3. 3Department of Clinical, Rome, Italy
  4. 4Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy mariavittoria.carbone1@policlinicogemelli.it, Rome, Italy
  5. 5comprehensive cancer center Agostino Gemelli University polyclinic IRCCS Rome, Roma, Italy
  6. 6Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  7. 7comprehensive cancer center Agostino Gemelli University polyclinic IRCCS Rome, Roma, ItalyDipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  8. 8Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione
  9. Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  10. 9Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy, Rome, Italy
  11. 10Department of Women’s and Children’s Health, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
  12. 11Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

Abstract

Introduction/Background In the treatment of gynecological tumors, taxanes currently represent the main chemotherapeutic drugs to be used in clinical practice. A minority of patients experience allergic reactions limiting the possibilities for oncological treatment (1–10%). Several desensitization protocols were proposed to overcome the hypersensitivity and guarantee the appropriate treatment to the patients. We reviewed retrospectively the safety and efficacy of a rapid desensitization protocol in patients with gynecological cancers.

Methodology We reported data of patients who experienced hypersensitivity reactions to paclitaxel occurring during or shortly (≤48 hours) from 2018 to 2020. The patients had premedication three days before the infusion with desensitization protocol (three solutions 1/100, 1/10 and 1/1 undiluted paclitaxel: 3 bags/12 steps).

Results 80 patients experienced reaction to taxol: 61 ovarian cancer (76.25%), 12 endometrial cancer (15%), 3 cervical cancer (3.75%) and 4 synchronous ovarian/endometrial cancer (5%) with advanced stage at diagnosis in 62% of cases. Thirteen patients (16.25%) reported a personal history of drug allergy and seven patients (8.75%) of autoimmune diseases. More than 50% of the reactions recorded are moderate and severe in a median time of 11.24 minutes from the beginning of infusion (3–60). Most patients reacted on the first infusion (68%). The number of cycles before the hypersensitivity reaction is 1.64 (1–12 cycles). All patients performed skin tests (ST) after a median time of 18.5 days from reaction (2–90). 65% of patients underwent treatment based on desensitization protocol: 286 cycles were performed in all cohorts and only in sixteen cases we reported a reaction to paclitaxel despite premedication and desensitization schedule. In three patients with a positive ST a desensitization schedule was administered but only one completed therapy without further reactions.

Conclusion Desensitization programs could manage hypersensitivity reactions to taxanes without limiting the possibilities of access to a primary standard of care in gynecological cancers.

Disclosures The authors declare that they have no competing interests.

https://doi.org/10.1136/ijgc-2024-ESGO.535

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