Predictors of immediate and delayed cutaneous hypersensitivity reactions to paclitaxel.
Humans
Paclitaxel
/ adverse effects
Female
Middle Aged
Retrospective Studies
Adult
Risk Factors
Aged
Hypersensitivity, Delayed
/ diagnosis
Breast Neoplasms
/ drug therapy
Hypersensitivity, Immediate
/ epidemiology
Drug Eruptions
/ etiology
Antineoplastic Agents, Phytogenic
/ adverse effects
Drug Hypersensitivity
/ epidemiology
Age Factors
Allergy
Breast cancer
Hypersensitivity reaction
Paclitaxel
Rash
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
09 Oct 2024
09 Oct 2024
Historique:
received:
07
06
2024
accepted:
14
09
2024
revised:
17
08
2024
medline:
9
10
2024
pubmed:
9
10
2024
entrez:
9
10
2024
Statut:
epublish
Résumé
Paclitaxel is one of the first-line treatments for breast, ovarian, and lung cancers. However, its use is limited by the high frequency of hypersensitivity reactions. In this retrospective chart review at Memorial Sloan Kettering Cancer Center, we assess clinical factors associated with immediate and delayed hypersensitivity reactions to paclitaxel and characterize delayed hypersensitivity reactions to paclitaxel in patients with breast cancer. 12,274 patients were treated with paclitaxel. 6,165 had breast cancer and 1,233 were seen by a dermatologist. 734 patients (11.9%) developed an immediate hypersensitivity reaction. Age (p < 0.001), race (p < 0.001), and prior history of allergy (p = 0.05) were associated with immediate hypersensitivity reactions. 147 patients (4.0%) had a rash of interest. The most common phenotypes were maculopapular (52%) and urticaria (36%). Race (p < 0.001) and history of allergy (p < 0.001) were associated with development of a cutaneous reaction. Patients with an immediate hypersensitivity reaction were more likely to have developed a delayed cutaneous reaction (OR = 1.80). Risk factors for development of immediate hypersensitivity reactions in this study were younger age, race, and history of allergy. Patients who developed an immediate hypersensitivity reaction were more likely to develop a delayed hypersensitivity reaction. Risk factors for development of the rash included Asian race and history of allergy. Identification of risk factors is critical to guide care coordination. Awareness of these clinical factors which are associated with development of a rash could guide providers in choosing treatment with paclitaxel or nab-paclitaxel. If the cutaneous reactions are bothersome to the patient, the transition of treatment from paclitaxel to nab-paclitaxel may be warranted, or a consideration of re-challenge or desensitization may be discussed.
Identifiants
pubmed: 39382584
doi: 10.1007/s00403-024-03402-5
pii: 10.1007/s00403-024-03402-5
doi:
Substances chimiques
Paclitaxel
P88XT4IS4D
Antineoplastic Agents, Phytogenic
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
665Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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