Options in Hypersensitivity Reactions to Chemotherapeutics

Opinion statement

Purpose of review

Chemotherapeutic drugs still represent a gold standard for the treatment of neoplastic disease. They can induce hypersensitivity reactions and are the third leading cause of fatal drug-induced anaphylaxis in the USA. This article has tried to highlight and summarize the most recent scientific progress concerning risk factors, pathogenesis, diagnosis, and treatment of these reactions.

Recent findings

Identification of patients at high risk of developing hypersensitivity reactions allows risk stratification to guide clinical decision-making. Therefore, the most recent researches evaluated the possibility to perform risk stratification in case of hypersensitivity reactions to platinum compounds and taxanes. In addition, new data are now available regarding the role of in vitro test for the diagnosis of reactions to platins and the role of drug provocation test in case of hypersensitivity to a number of chemotherapeutics. However, actually, the allergological work-up includes a very careful anamnesis of the patient and the characteristics of reaction, whereas skin tests are useful only for few classes of chemotherapy, namely platinum salts and probably taxanes. Premedication, desensitization and, in some cases, skin tests are able to prevent the majority of hypersensitivity reactions, permitting the administration of the most effective therapy.

Summary

Clearly, more studies are needed to better understand, diagnose, treat, and prevent these reactions. To reach this aim, a multidisciplinar approach to the cancer patient with potential allergies is needed.

from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2FTXS6z