New Research: for Nancy & others with alleric reaction to carboplatin & other chemo drugs

lindaprocopio
lindaprocopio Member Posts: 1,980
edited March 2014 in Ovarian Cancer #1
Successful Outpatient Desensitization of Cancer Patients With Hypersensitivity Reactions to Chemotherapy

GR Gottlieb, RE Bordoni, RA Lawhead, BA Feinberg; 2010 Oct 1 ; "Community Oncology" magazine.

Abstract
Hypersensitivity reactions (HSRs) to chemotherapy agents occur with relatively high frequency with some of the most broadly used chemotherapeutic drug classes, including taxanes, platinum compounds, and monoclonal antibodies. Solvents, such as the Cremophor EL in paclitaxel, and preservatives, such as the polysorbate 80 in docetaxel, have also been implicated. HSRs have been observed both immediately upon first exposure and delayed after months of exposure. Due to the risk of life-threatening anaphylaxis, the traditional response to an HSR is immediate cessation and lifelong prohibition of the offending agent. After cessation of the HSR-inducing drug, patients are then usually switched to an alternative chemotherapy regimen that may not be as effective. From May 2009 to April 2010, we performed 60 desensitization procedures in 18 patients using a desensitization protocol consisting of three essential elements: (1) administration by stepwise graded dosing, (2) premedications, and (3) close supervision by an experienced allergist. Fifty-eight of the 60 planned chemotherapy infusions were completed with the full dose delivered. Our data show that most cancer patients with allergic reactions to chemotherapy agents (platinum compounds and taxanes) or a monoclonal antibody (rituximab) can be desensitized safely in an outpatient setting.

Full article: http://www.communityoncology.net/journal/articles/0710452.pdf

Comments

  • nancy591
    nancy591 Member Posts: 1,027 Member
    thanks
    I know I was already on a 'desensitized' rate of infusion and of course I had pre-meds. I am not sure how long my infusion was scheduled for. I did ask about getting it again over a longer period of time etc. etc. Doc said he wouldnt do it at this time. Wants to try other things first.

    For anyone who is interested MSKCC is doing a Carbo desensitized rate trial. If you already had an allergic reaction you do not qualify. GO FIGURE!!!! here is the protocol:


    Full Title :
    STANDARD INFUSION CARBOPLATIN VERSUS PROPHYLACTIC EXTENDED INFUSION CARBOPLATIN IN THE TREATMENT OF PATIENTS WITH RECURRENT, PLATINUM-SENSITIVE, OVARY, FALLOPIAN TUBE, AND PRIMARY PERITONEAL CANCER
    Purpose :
    Patients who have recurrent ovarian, fallopian tube, or peritoneal cancer are often treated with several drugs. Carboplatin is one that seems to work for many treatment cycles. Even though it may work against the cancer, patients can become allergic to it. If that happens, treatment with the drug usually needs to be stopped.

    Some patients have received carboplatin over three hours instead of 30 minutes. They had fewer allergic reactions than expected. Doctors do not know if this was because of the way they got carboplatin or because of some other factor.

    The purpose of this study is to see if giving carboplatin over three hours prevents allergic reactions to the drug, and to see if giving certain other medications before the carboplatin can help reduce allergies. Some patients may receive other chemotherapy drugs as part of their treatment in addition to carboplatin.

    Eligibility :
    To be eligible for this study, patients must meet several criteria, including but not limited to the following:

    Patients must have ovarian, fallopian tube, or peritoneal cancer that has recurred following one or two regimens of prior platinum-based chemotherapy.
    Disease must have relapsed six or more months following completion of platinum-based therapy.
    Patients who had a prior allergic reaction to carboplatin or cisplatin may not participate.
    Patients must be able to be ambulatory for more than half of their normal waking hours.
    Patients must be age 21 or older.
    For more information about this study and to inquire about eligibility, please contact Dr. Roisin O'Cearbhaill at 212-639-4820.
  • froggy1
    froggy1 Member Posts: 205
    nancy591 said:

    thanks
    I know I was already on a 'desensitized' rate of infusion and of course I had pre-meds. I am not sure how long my infusion was scheduled for. I did ask about getting it again over a longer period of time etc. etc. Doc said he wouldnt do it at this time. Wants to try other things first.

    For anyone who is interested MSKCC is doing a Carbo desensitized rate trial. If you already had an allergic reaction you do not qualify. GO FIGURE!!!! here is the protocol:


    Full Title :
    STANDARD INFUSION CARBOPLATIN VERSUS PROPHYLACTIC EXTENDED INFUSION CARBOPLATIN IN THE TREATMENT OF PATIENTS WITH RECURRENT, PLATINUM-SENSITIVE, OVARY, FALLOPIAN TUBE, AND PRIMARY PERITONEAL CANCER
    Purpose :
    Patients who have recurrent ovarian, fallopian tube, or peritoneal cancer are often treated with several drugs. Carboplatin is one that seems to work for many treatment cycles. Even though it may work against the cancer, patients can become allergic to it. If that happens, treatment with the drug usually needs to be stopped.

    Some patients have received carboplatin over three hours instead of 30 minutes. They had fewer allergic reactions than expected. Doctors do not know if this was because of the way they got carboplatin or because of some other factor.

    The purpose of this study is to see if giving carboplatin over three hours prevents allergic reactions to the drug, and to see if giving certain other medications before the carboplatin can help reduce allergies. Some patients may receive other chemotherapy drugs as part of their treatment in addition to carboplatin.

    Eligibility :
    To be eligible for this study, patients must meet several criteria, including but not limited to the following:

    Patients must have ovarian, fallopian tube, or peritoneal cancer that has recurred following one or two regimens of prior platinum-based chemotherapy.
    Disease must have relapsed six or more months following completion of platinum-based therapy.
    Patients who had a prior allergic reaction to carboplatin or cisplatin may not participate.
    Patients must be able to be ambulatory for more than half of their normal waking hours.
    Patients must be age 21 or older.
    For more information about this study and to inquire about eligibility, please contact Dr. Roisin O'Cearbhaill at 212-639-4820.

    I'm confused
    I'm not real familiar with studies, but if you were able to tolerate carboplatin, why would you do this study?(Patients who had a prior reaction may not participate) Just on the outside chance you might have a reaction? I know they do a wheel test on me each treatment and I hold my breath waiting for a lump to appear. So far, so good. They did say they would try more premeds and a slower infusion before they decided not to give it to me. This is my second round of carbo... Ginny
  • froggy1
    froggy1 Member Posts: 205
    nancy591 said:

    thanks
    I know I was already on a 'desensitized' rate of infusion and of course I had pre-meds. I am not sure how long my infusion was scheduled for. I did ask about getting it again over a longer period of time etc. etc. Doc said he wouldnt do it at this time. Wants to try other things first.

    For anyone who is interested MSKCC is doing a Carbo desensitized rate trial. If you already had an allergic reaction you do not qualify. GO FIGURE!!!! here is the protocol:


    Full Title :
    STANDARD INFUSION CARBOPLATIN VERSUS PROPHYLACTIC EXTENDED INFUSION CARBOPLATIN IN THE TREATMENT OF PATIENTS WITH RECURRENT, PLATINUM-SENSITIVE, OVARY, FALLOPIAN TUBE, AND PRIMARY PERITONEAL CANCER
    Purpose :
    Patients who have recurrent ovarian, fallopian tube, or peritoneal cancer are often treated with several drugs. Carboplatin is one that seems to work for many treatment cycles. Even though it may work against the cancer, patients can become allergic to it. If that happens, treatment with the drug usually needs to be stopped.

    Some patients have received carboplatin over three hours instead of 30 minutes. They had fewer allergic reactions than expected. Doctors do not know if this was because of the way they got carboplatin or because of some other factor.

    The purpose of this study is to see if giving carboplatin over three hours prevents allergic reactions to the drug, and to see if giving certain other medications before the carboplatin can help reduce allergies. Some patients may receive other chemotherapy drugs as part of their treatment in addition to carboplatin.

    Eligibility :
    To be eligible for this study, patients must meet several criteria, including but not limited to the following:

    Patients must have ovarian, fallopian tube, or peritoneal cancer that has recurred following one or two regimens of prior platinum-based chemotherapy.
    Disease must have relapsed six or more months following completion of platinum-based therapy.
    Patients who had a prior allergic reaction to carboplatin or cisplatin may not participate.
    Patients must be able to be ambulatory for more than half of their normal waking hours.
    Patients must be age 21 or older.
    For more information about this study and to inquire about eligibility, please contact Dr. Roisin O'Cearbhaill at 212-639-4820.

    dubble post- sorry
    goofed
  • nancy591
    nancy591 Member Posts: 1,027 Member
    froggy1 said:

    I'm confused
    I'm not real familiar with studies, but if you were able to tolerate carboplatin, why would you do this study?(Patients who had a prior reaction may not participate) Just on the outside chance you might have a reaction? I know they do a wheel test on me each treatment and I hold my breath waiting for a lump to appear. So far, so good. They did say they would try more premeds and a slower infusion before they decided not to give it to me. This is my second round of carbo... Ginny

    alleric reaction
    Because the risk of reaction increase with every additional infusion. I was told that most people start having alleric reactions after the 8th infusion. So the whole purpose of this study is to start with the slow infusion right for the start. Or if you already exceeded a higher number of infusions and are at an increased risk of allergic reactions you can/should start receiving at a slower infusion rate. They are studying to see if going at a very slow rate will cut down on alleric reactions.

    When I restart carbo after a year of being off of it I was started at a desensitized rate WITHOUT any history of problems. That is MSKCC standard protocol. Anything over 8 rounds is given slowly. I am not sure what the rate of infusion was but I had an allergic reaction at the completion of my 10th infusion. Bummer for me because the drop in the ca125 was the greatest I had since restarting chemo earlier that year. My reaction was not bad, in my opinion, and I'd be willing to try it again at a SLOWER rate with more pre-meds. Doc wants to wait on that and try other things first.

    How many infusions have you had total to date?
  • froggy1
    froggy1 Member Posts: 205
    nancy591 said:

    alleric reaction
    Because the risk of reaction increase with every additional infusion. I was told that most people start having alleric reactions after the 8th infusion. So the whole purpose of this study is to start with the slow infusion right for the start. Or if you already exceeded a higher number of infusions and are at an increased risk of allergic reactions you can/should start receiving at a slower infusion rate. They are studying to see if going at a very slow rate will cut down on alleric reactions.

    When I restart carbo after a year of being off of it I was started at a desensitized rate WITHOUT any history of problems. That is MSKCC standard protocol. Anything over 8 rounds is given slowly. I am not sure what the rate of infusion was but I had an allergic reaction at the completion of my 10th infusion. Bummer for me because the drop in the ca125 was the greatest I had since restarting chemo earlier that year. My reaction was not bad, in my opinion, and I'd be willing to try it again at a SLOWER rate with more pre-meds. Doc wants to wait on that and try other things first.

    How many infusions have you had total to date?

    Great info
    As always you have great info, Nancy. I have had 11 infusions total.(8 with the first series, 3 with this) I'm not sure if I didn't get a desensitized rate at the start of my last series. They did say the first infusion would take longer. Betweeen the carbo and doxil, I was hooked up from 8-4. I'm sure now that's what it was. I will have to pay more attention. My chemo team isn't real forthcoming unless asked! I guess now I need to study infusion rates! LOL
    Now I am REALLY apprehensive about the wheel test!
    I have been fortunate in that, so far, I have never had to stop a chemo because of a reaction or "bad" labs. I'm hoping it continues.
    Thanks so much for the info. It explains a lot.
    Ginny
  • tinacap77
    tinacap77 Member Posts: 27 Member
    edited October 2020 #7
    Anaphylaxis shock within 15 seconds of 1st round of Taxel

    I went into Anaphylaxis shock with 15 seconds of my first round of Taxel. Those nurses saved my life. i got admitted to the hospital, discharged and then one week later on 10/12/20, they admitted me to ICU and I received a new drug in same family as Taxel called Abraxane and also gave me the second drug for first time called Carboplaxin. It went well and Cycle 2 will be back in outpatient.