Abstract
Platinum-containing chemotherapy agents (cisplatin, carboplatin, oxaliplatin) have been approved in the first-line setting of numerous malignancies, such as ovarian, bladder, head and neck, colorectal, and lung cancer. Their extensive use over the last decade has led to a significant increase in the incidence of hypersensitivity reactions, which are defined as unforeseen reactions whose signs and symptoms cannot be explained by the known toxicity of these drugs. Skin rash, flushing, abdominal cramping, itchy palms, and back pain are common symptoms. Cardiovascular and respiratory complications can prove fatal. Multiple pathogenetic mechanisms have been suggested. Hypersensitivity usually appears after multiple infusions, suggesting type I allergic reactions; however, other types of hypersensitivity also seem to be implicated. Several management options are available to treating physicians: discontinuation of chemotherapy, premedication, prolonging of infusion duration, desensitization protocols, and replacement with a different platinum compound after performing skin tests that rule out cross-reactions among platinum agents.
Highlights
Platinum-based compounds were first synthesized in the nineteenth century but their clinical use against cancer did not start until the 1970s
Hypersensitivity reactions in patients receiving cisplatin were first described in the 1970s in patients who had been retreated with the drug [31]
The aim of this paper is to provide recent data concerning hypersensitivity reactions to platinum-containing chemotherapy agents
Summary
Platinum-based compounds were first synthesized in the nineteenth century but their clinical use against cancer did not start until the 1970s Their activity consists of forming DNA addicts that inhibit replication and lead to apoptosis [1, 2]. Platinum agents are effective in pediatric tumors [16, 17] They are used in the first-line and adjuvant setting and as retreatment regimens when there is a long progression-free interval after treating with the same drugs [18, 19]. Hypersensitivity to a chemotherapeutic agent is defined as an unforeseen reaction whose signs and symptoms cannot be explained by the known toxicity of the drug [29]. Hypersensitivity reactions in patients receiving cisplatin were first described in the 1970s in patients who had been retreated with the drug [31]. We will present the characteristics and pathogenetic mechanisms of this hypersensitivity, as well as the basic management options available to date
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