Abstract
Simple SummaryThis study was conducted to evaluate the safety and efficacy of weekly paclitaxel and cisplatin chemotherapy in patients with ovarian cancer who developed carboplatin hypersensitivity reaction. Eighty-six (86) patients who developed hypersensitivity reactions for carboplatin were treated with weekly paclitaxel and cisplatin chemotherapy, and 71 (83%) of the 86 patients were able to receive treatment without hypersensitivity reaction to cisplatin. The severity of the hypersensitivity reaction for cisplatin observed in all 15 patients was below grade 2, and there were no deaths due to hypersensitivity reaction to cisplatin. The majority of patients (55 patients, 64%) completed the scheduled weekly paclitaxel and cisplatin chemotherapy, and only 9 patients (10%) discontinued treatment due to hypersensitivity reaction within 6 cycles. Weekly paclitaxel and cisplatin chemotherapy were well-tolerated and effective for patients who developed carboplatin hypersensitivity reaction.Background: This study aimed to evaluate the safety and efficacy of weekly paclitaxel and cisplatin chemotherapy (wTP) in patients with ovarian cancer who developed carboplatin hypersensitivity reaction (HSR). Methods: We retrospectively investigated 86 patients with ovarian, fallopian tube, and peritoneal carcinoma who developed carboplatin HSR during previous chemotherapy (carboplatin and paclitaxel) at our institution between 2011 and 2019. After premedication was administered, paclitaxel was administered over 1 h, followed by cisplatin over 1 h (paclitaxel 80 mg/m2; cisplatin 25 mg/m2; 1, 8, 15 day/4 weeks). We investigated the incidence of patients who successfully received wTP for at least one cycle, treatments compliance, progression-free survival (PFS), and overall survival (OS). Results: The median number of wTP administration cycles was 4 (Interquartile Range IQR, 3–7), 71 patients (83%) successfully received wTP, and 15 patients (17%) developed cisplatin HSR. The efficacy of treatment was as follows: 55 (64%) patients completed the scheduled wTP, 9 (10%) patients discontinued due to HSR to cisplatin within 6 cycles, 1 (1%) patient discontinued due to renal toxicity (grade 2) at the 6th cycle, and 21 (24%) patients discontinued due to progressive disease within 6 cycles. The median PFS and OS after administration of wTP were 10.9 months (95% CI: 7.7–17.7) and 25.9 months (95% CI: 19.0–50.2), respectively. Conclusions: wTP was safe and well-tolerated in patients who developed carboplatin HSR.
Highlights
The standard therapy for platinum-sensitive recurrent ovarian cancer is a platinumbased chemotherapy plus bevacizumab (Bev) [1] or poly polymerase (PARP) inhibitor maintenance [2] in case of response to platinum, and it is influenced by the first-line treatment
This study investigated consecutive patients over an 8-year period who received identical regiments of weekly paclitaxel and cisplatin chemotherapy (wTP) owing to the occurrence of hypersensitivity reaction to carboplatin
86 patients who developed hypersensitivity reactions to carboplatin were treated with wTP, and 83% of the patients were able to continue the treatment without a hypersensitivity reaction to cisplatin There were no deaths due to hypersensitivity reaction to cisplatin
Summary
The standard therapy for platinum-sensitive recurrent ovarian cancer is a platinumbased chemotherapy plus bevacizumab (Bev) [1] or poly (adenosine diphosphate [ADP]ribose) polymerase (PARP) inhibitor maintenance [2] in case of response to platinum, and it is influenced by the first-line treatment (use of Bev or PARPi). One of the problems in the treatment of platinum-sensitive recurrent ovarian cancers is the occurrence of carboplatin hypersensitivity reaction (HSR) [7]. The absence of platinum administration due to carboplatin hypersensitivity reaction makes it difficult to determine the platinum sensitivity of each patient; they cannot benefit from poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitors [2], for which platinum sensitivity is a clinical biomarker [8]. This study aimed to evaluate the safety and efficacy of weekly paclitaxel and cisplatin chemotherapy (wTP) in patients with ovarian cancer who developed carboplatin hypersensitivity reaction (HSR). Conclusions: wTP was safe and well-tolerated in patients who developed carboplatin HSR
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