Abstract
Patients with non-small cell lung cancer (NSCLC) who have received more than one cycle of platinum-based chemotherapy in their lifetime may be at risk of hypersensitivity. The overall incidence of hypersensitivity to carboplatin ranges from 1% to 27% and that of hypersensitivity to carboplatin is between 5% and 20%. However, the actual incidence of cross-reactivity between platinum salts has not yet been known. In this paper, we reported a case of a 39-year-old man with advanced non-small cell lung cancer, who had cisplatin anaphylaxis after having had carboplatin hypersensitivity at the previous cycle. The anaphylactic reaction was managed successfully with adrenaline, corticosteroids, antihistamines, oxygen mask and isotonic fluid support. No further reactions were observed and after that he stopped the platinum regimen. This case illustrates that NSCLC patients may experience hypersensitive and cross-reactivity to both carboplatin and cisplatin. It is important to be aware of the possibility of anaphylaxis so that appropriate premedication or effective treatment can be promptly instituted.
Highlights
Worldwide, lung cancer remains the leading cause of cancer death, with an estimated 1.8 million deaths (18%) in 2020 [1]
Patients with non-small cell lung cancer (NSCLC) who have received more than one cycle of platinum-based chemotherapy in their lifetime may be at risk of hypersensitivity
We reported a case of a 39-year-old man with advanced non-small cell lung cancer, who had cisplatin anaphylaxis after having had carboplatin hypersensitivity at the previous cycle
Summary
Lung cancer remains the leading cause of cancer death, with an estimated 1.8 million deaths (18%) in 2020 [1]. Platinum-based chemotherapy is still the standard treatment for most patients with recurrent or advanced NSCLC [2]. Carboplatin and cisplatin have been shown to be effective chemotherapeutics and can be used to treat many solid tumors. The rate of hypersensitivity to cisplatin is similar to that of carboplatin It is between 5% and 20% and increases with concomitant radiation [7]. With the patient’s consent, we report a case of hypersensitivity and cross-reactivity to cisplatin and carboplatin in a patient with stage IIIb NSCLC. Through presenting this case report, we hope to raise doctors’ and nurses’ awareness on the possibility of platinum hypersensitivity in the lung cancer patients
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