oxaliplatin reaction

DK2006 · April 2006

Hi all,
Two weeks ago I received my 7th treatment of Folfox. All was going well for about a hour until I started to have an adverse reaction to the oxaliplatin. I broke out in hives, turned completely red, and I thought my head would explode. The nurses stopped treatment and gave me Benadryl and I was eventually able to finish my leucovorin and bolus 5 FU and the 5 FU pump. Well, my 8th treatment is this week. My oncologist wants me to take steroids and anti-histamines the night before and morning of treatment and wants to try the oxaliplatin again. I've done a literature search on oxaliplatin hypersensivity, and all the literature says that once you become allergic to the oxaliplatin, the benefits should way outway the risks before getting it any more. I'm thinking of stopping the oxaliplatin and doing only the leucovorin and 5 FU. I'm very scared of having another anaphylactic reaction. My question is..what would you do? I have stage 3a colon cancer. (1 out of 32 lymph nodes positive.) I had been tolerating the folfox fine up to this treatment. I did want to be as aggresive as possible, but now I think it's time to back off. Thanks in advance for any advice. Donna

Kanort · April 2006

Hi Donna,

I am so sorry about your reaction. I'm wondering if extending the time for administration of the oxaliplatin from two hours to three hours would make any difference? After my eight treatment of Folfox, my liver panels were elevated and I had to stop oxaliplatin until they corrected themselves. However, instead of stopping oxal., my oncologist just extended the administration time, and I was able to complete all 12 cycles with no problem.
However, I can also understand your fear of the adverse reaction happening again.

Let us know about your final decision and all my best to you.

Kay

KathiM · April 2006

Kanort said:
Hi Donna,

I am so sorry about your reaction. I'm wondering if extending the time for administration of the oxaliplatin from two hours to three hours would make any difference? After my eight treatment of Folfox, my liver panels were elevated and I had to stop oxaliplatin until they corrected themselves. However, instead of stopping oxal., my oncologist just extended the administration time, and I was able to complete all 12 cycles with no problem.
However, I can also understand your fear of the adverse reaction happening again.

Let us know about your final decision and all my best to you.

Kay

I agree totally, Kay.
After finishing my CRC, I have been wrestling with breast CA. One of the chemo's is Taxol.
My onc told me that they would administer REALLY slowly, side effect was allergic reaction.
I insisted this happen with each infusion...very slow....I figured better to stay longer, still get the chemo, than to have a reaction and have to stop.

Hugs, Donna....keep the chin up.

Kathi

JoyceCanada · April 2006

hi Donna: I only managed 2 treatments of oxaliplatin. Treatment 1 was a "honeymoon" felt fine no severe side effects. Treatment 2 was awful I spiked a very high temperature 38.9C and I felt as though I was burning from the inside out. Very red face and body which lasted for a few days. My face looked as though I had spent the day in the wind and sun - red along my cheek bones and neck area. Oncologist said "no more oxaliplatin - I'm here to cure you not kill you"!!
I was scheduled to go for my readiation/chemo continuous treatment but it had to be cancelled for 1 week because of very low platelet counts.

I have now completed 5 treatments of radiation/chemo and apart from a red butt, slightly upset stomach, I'm doing just fine.

I don't know what I will be on when the radiation/chemo is finished. I know it will not be oxaliplatin.

My guess is that I'll be on 5FU/lev which is the old standard treatment.

I like you was very upset that I can't have the Oxaliplatin I wanted to go to the most "agressive" treatment....I'm stage III x 2 lymph mode involved.

I have to trust the judgement of my oncologist!!

I've been assured that thousands have been cured using 5FU.

CAMaura · April 2006

Hi Donna,

I was on Folfox last year, and I had reactions to the Oxy as well; I think mine started around session six. I was pretreated with Benadryl and Decadron, and I think the combo helped for about two sessions. Then, my body pushed right through to continue an allergic reaction (blood pressure spike, extreme splotchiness chest). This went along with my liver panel going up and up. I stopped chemo; might seem radical for some, but to me it was my body telling me that it was full and finito with the chemicals. I finished nine sessions out of 12. I have no regrets about stopping the process. All the best to you and I hope you are happy with your decisions. It is tough...we have mixed feelingsa bout wanting to continue something which makes us feel so poorly. I hope a good discussion with your docs will be fruitful and calm your anxiety. Check out your bloodwork pretty carefully too. Take care - Maura

shmurciakova · April 2006

Hi there,
You might ask your doctor about Folfiri (Camptosar) instead. That is what I was on. If you do decide to quit, however, you did only have one lymph node involved and I think I had 4 if memory serves me right.....The fewer lymph nodes the better your chances are of being cured. When I was first diagnosed, Oxaliplatin did not even exist. I am surprised they are using it for a first line treatment now. My doc indicated that he wanted to "save it" for the future just in case......anyway, that was several years ago, so things have probably changed by now.
Good luck with your decision. If I were you I would probably just stop taking it, but it is ultimatley your decision.
-Susan.

jerseysue · April 2006

I am stage 4 and my oxaliplatin reaction was on the 9th treatment. Just like you my palms started to itch and they stopped the oxi and continued with the rest of the protocol. After that my onc just didn't give me anymore oxi.

Betsydoglover · April 2006

Donna, I am sorry about your reaction. I had six cycles of Xeloda/oxaliplatin/Avastin and never had an allergic reaction. You may want to stop the oxy for a while. Hoping to make you feel better by letting you know that I am Stage IV with an identified liver met and have been negative since my 2nd chemo cycle. So you are "only" stage III and may well be quite fine without further pursuing the oxaliplatin. The big irony is that some of us Stage IV patients actually have less chemo than you Stage III guys, because in our case there is "something" to watch in order to determine best response. In your case it is more, keep on pushing it for many cycles and we are probably ok. So, that's the best thing I can say about Stage IV CRC, but I also hope it helps you be comfortable if you decide to forgo further oxaliplatin treatments.

BEtsy

JADot · April 2006

Hi Donna:

Sorry to hear about your scary experience. There's been so much good advise given here, and I don't have anything different to add, except to wish you the best luck with this. You're doing the absolute right thing by questioning the regimen and make changes when needed.

My own experience w/ Oxaliplatin hasn't been too bad other than the peripheral neuropathy. I did get flushed face, pounding heart and increased blood pressure for several weeks. Last cycle I declined one of the steroid-based nausea medicine and all the problems went away. I did throw up twice but I consider that reasonable trade-off for cardiac overload.

I know a lot of people who were cured on 5FU alone. Oxaliplatin is a hot new and expensive drugs now, so it gets prescribed a lot. The data out there shows only 5-10% incremental improvement of Oxaliplatin over just 5FU. So given your experience, it's wise to question the use of it, unless they can find some way to give it to you safely.

Again, best of luck Donna!

Cheers,
JADot

JoyceCanada · April 2006

Betsydoglover said:
Donna, I am sorry about your reaction. I had six cycles of Xeloda/oxaliplatin/Avastin and never had an allergic reaction. You may want to stop the oxy for a while. Hoping to make you feel better by letting you know that I am Stage IV with an identified liver met and have been negative since my 2nd chemo cycle. So you are "only" stage III and may well be quite fine without further pursuing the oxaliplatin. The big irony is that some of us Stage IV patients actually have less chemo than you Stage III guys, because in our case there is "something" to watch in order to determine best response. In your case it is more, keep on pushing it for many cycles and we are probably ok. So, that's the best thing I can say about Stage IV CRC, but I also hope it helps you be comfortable if you decide to forgo further oxaliplatin treatments.

BEtsy

Betsy: I'm happy to hear that you were negative after 2 cycles. My oncologist seems to think that 2 cycles of oxi will prove to be all that I need. She is going to check with the manufacturer of Oxi --- but honestly the reaction was so frightening I don't think it is wise for me to receive any further treatment with Oxi. I have to listen to my body and it sure did tell me that something "wasn't right"......still have nightmares of the "burning sensation". Husband was minutes away from calling 911.

Everyone reacts differently - I was just one of the "unlucky" ones.

taraHK · April 2006

Hi Donna,
Sorry to hear about this reaction. If you and your doctor do decide to proceed with the oxaliplatin, with all the steroids and antihistamines, may I suggest that you request to be monitored very carefully. Severe allergic reactions have been noted with oxali. I wish you best of luck. I was able to complete 11 out of 12 folfox treatments. I had swollen lips but that was all in terms of allergic reaction.
Tara

oxaliplatin reaction

Comments

Discussion Boards