Prophylactic Anti-allergic Drug Administration to Prevent Docetaxel and Cyclophosphamide-induced Skin Toxicity: Sub-analysis of a Multiinstitution Neoadjuvant Chemotherapy Trial in Primary Breast Cancer Patients

Abstract

Background: TC (a combination of 75 mg/m2 docetaxel and 600 mg/m2 cyclophosphamide q3W) is used for neoadjuvant/adjuvant chemotherapy in the treatment of primary breast cancer. We have recently encountered many cases of skin eruption related to TC therapy, but the effectiveness of prophylactically using anti-allergic drugs remains unclear. In this study, we aimed to determine whether the prophylactic use of anti-allergic drugs could be beneficial for the prevention of TC-related skin toxicity. Methods: We retrospectively investigated the incidence of skin eruption related to TC or a combination of docetaxel, cyclophosphamide, and trastuzumab (HER-TC) among patients with or without prophylactic anti-allergic drug administration by performing a sub-analysis of data from a previous clinical trial. For neoadjuvant chemotherapy (NAC), four cycles of either TC or HER-TC (docetaxel: 75 mg/m2; cyclophosphamide: 600 mg/m2; trastuzumab: 6 mg/kg loading dose, then 8 mg/kg thereafter) were administered intravenously every 3 weeks. 120 mg per day of fexofenadine (an antihistamine) was administered from the first day of TC or HER-TC treatment until three weeks after completion of the four cycles of TC/HER-TC treatment. Results: Four cycles of TC or HER-TC therapy were administered to 94 patients. The incidence of skin eruption with and without prophylactic drug administration was 27.7% (26/38) and 10.6% (10/56), respectively, indicating that prophylactic anti-allergic drug usage did not decrease the incidence of skin eruption. Conclusions: Administration of prophylactic anti-allergic drugs may not be useful for prevention of TC- or HERTC– related skin eruption.