Desensitization in patients hypersensitive to platinum compounds in gynecologic oncology

Abstract

The treatment of ovarian cancer based on platinum analogs has taken on a new and additional importance in recent years. The introduction of modern maintenance therapy — PARP inhibitors — has significantly prolonged the time to progression in recurrent and newly diagnosed ovarian cancer and clinically meaningful, as per SOLO-2 results, prolonging overall survival in recurrent disease. This is an absolute breakthrough in the treatment of advanced forms of this cancer. Sensitivity to platinum is a prerequisite for the efficacy of this therapy as well as patient eligibility for treatment. Hypersensitivity issues can significantly limit access to this modern and effective maintenance therapy. Platinum hypersensitivity usually occurs in subsequent lines of therapy and with subsequent cycles of treatment. Hypersensitivity reactions cannot always be predicted, despite known risk factors. In order to maintain platinum-based treatment, we can modify premedication modalities, but appropriate desensitization protocols seem to be most effective. This article describes the most commonly used desensitization methods in patients with ovarian cancer and platinum hypersensitivity in a practical way, e.g., as they are used in the centers where the authors of this publication practice.