Survey of carboplatin desensitization therapy: JCOG Gynecologic Cancer Study Group multicenter retrospective study.

Abstract

e17631 Background: The purpose of the present study was to investigate the real-world experience with carboplatin desensitization (CD) therapy in Japan, along with its safety, and establish a strategy to address carboplatin-induced hypersensitive reactions (HSRs). Methods: The present study included patients diagnosed with gynecologic cancer (ovarian, endometrial, or cervical cancer, i.e., OC, EC, and CC, respectively) who underwent CD therapy between 2016 and 2020 at Japan Clinical Oncology Group Gynecologic Cancer Study Group (JCOG-GCSG) participating centers. CD therapy was performed at each institution, and cases of implementation were registered in online case report forms. We examined patient information, treatment regimens, frequency and dose of carboplatin administration, administration rates, and CD practices. This study was approved by the Ethics Committee of the Tottori University. Results: Overall, 20 of 51 JCOG-GCSC-participating facilities performed CD therapy. The present study enrolled 136 patients (OC, 108; EC, 17; CC, 11). Of these, 37 (27.2%) patients had pre-existing allergies, and 29 (20.5%) exhibited prodromal symptoms at the time of treatment prior to the onset of HSRs. The most common symptoms were erythema and itching. At the onset of HSRs, erythema was the most common symptom, occurring in 93 (68.4%) patients, followed by itching in 72 (52.9%), reduced oxygen saturation in 43 (31.6%), and loss of consciousness in 3 (2.2%). The onset of HSRs was most common during treatment of the first recurrence (47%). The mean total carboplatin dose until the appearance of HSRs was 7331 (2620–18282) mg, and the mean number of doses was 14 (4–63). Six centers discontinued CD therapy owing to the appearance of breakthrough HSRs. CD therapy was completed in 75% of patients, with 25% (34/136) experiencing breakthrough HSRs. HSR-related mortality was not observed. The associated risk factors with HSR were not selected in the present study. Conclusions: Although patients who undergo CD therapy in Japan have a high probability of safely completing planned therapy, erythema and pruritus are important signs of breakthrough HSRs. Breakthrough HSRs were most frequent during the first cycle of desensitization. [Table: see text]