Paclitaxel, a mitotic inhibitor, is used to treat a variety of cancers. A significant incidence of paclitaxel-related hypersensitivity reactions (HSRs) occurs because of the diluent used. Premedication with dexamethasone, diphenhydramine, and H2-histamine antagonists has markedly decreased the incidence of HSRs However, paclitaxel and docetaxel, which are the most commonly used taxanes, elicit immediate hypersensitivity reactions (HSRs) in 5% to 10% of patients. Almost all patients that experience these reactions can be safely re-exposed to taxanes either through desensitization or challenge Hypersensitivity reactions are a well-recognized complication of paclitaxel therapy and typically occur with the first or second dose [ 3 ]. These reactions are characterized by dyspnea, hypotension, bronchospasm, urticaria, and erythematous rashes. Respiratory symptoms may develop hours to weeks after paclitaxel administration Paclitaxel Paclitaxel (taxol) is a natural compound, originally isolated from the bark of the Pacific yew tree (Taxus brevifolia )inthe 1960s, with potent anticancer properties . It exerts its antineoplastic effects by interfering with the dynamics of microtubules (components of the cell cytoskeleton) thereb
Background: Hypersensitivity reactions (HSRs) are a common impediment to paclitaxel therapy. Management strategies to guide care after a paclitaxel-induced HSR are needed. Objective: The objective was to evaluate the utility and safety of risk stratification on the basis of severity of the initial HSR. Methods: A risk stratification pathway was developed on the basis of a retrospective review. . Of 301 patients treated, 32 patients have had definite (27 patients) or possible (five patients) hypersensitivity reactions to taxol. All but one patient had the reaction from the first or second exposure to this agent Hypersensitivity reactions (HSR) to paclitaxel occur in less than 10% of infusions, and the use of dexamethasone and histamine receptor antagonists decreased the incidence of severe reactions to.. Paclitaxel is contraindicated in patients who have a history of hypersensitivity reactions to Paclitaxel or other drugs formulated in polyoxyl 35 castor oil. Paclitaxel should not be used in patients with solid tumors who have baseline neutrophil counts of <1,500 cells/mm 3 or in patients with AIDS-related Kaposi's sarcoma with baseline.
The taxanes (paclitaxel, docetaxel and cabazitaxel) are widely prescribed antineoplastic agents commonly associated with HSRs. These reactions are categorised as either immediate or non-immediate, and clinical presentations can vary from mild flushing and pruritus, to severe anaphylaxis and death. r Many patients receiving paclitaxel experience mild to severe infusion-related hypersensitivity reactions, such as uticaria, facial flushing, shortness of breath, angioedema, and anaphylaxis. Most.. Hypersensitivity reactions to platinum compounds, such as carboplatin and oxaliplatin, are generally consistent with type 1 IgE‐mediated hypersensitivity [ 7, 8 ]
Hypersensitivity reactions to chemotherapy drugs pose significant difficulties in management, especially when no suitable alternative is available or acceptable and delay in continuation of treatment may be life-threatening. Such reactions may be IgE- or non-IgE-mediated and have varied manifestations. Timely recognition and treatment of life-threatening hypersensitivity reactions are essential The occurrence of hypersensitivity reactions does not preclude rechallenge with paclitaxel. In the event of a hypersensitivity reaction, the patient may be rechallenged the same day after additional premedication, slowing th Hypersensitivity reactions (HSRs) to paclitaxel are frequently encountered in patients receiving this antitumour drug. Administration of histamine H1- and H2-receptor antagonists and. Three patients were rechallenged with paclitaxel after the development of hypersensitivity; all tolerated rechallenge without further infusion reactions. Conclusion: A modified dexamethasone premedication regimen is a safe and convenient option with a low risk of hypersensitivity
To evaluate single-dose intravenous (IV) dexamethasone as a viable alternative to the standard two-dose oral protocol and as a method for the administration of corticosteroid prophylaxis in the prevention of paclitaxel-induced hypersensitivity reactions (HSR) Paclitaxel hypersensitivity may be an anaphylactoid or IgE reaction. They tend to occur early, during the first or second infusion, said Christen. When encountering a hypersensitivity reaction to paclitaxel, interrupt the infusion and administer protocol medicines—corticosteroids, diphenhydramine, and albuterol, she said Nab-paclitaxel has several practical advantages over Cremphor-EL-paclitaxel, including a shorter infusion time (30 min) and no need for premedications for hypersensitivity reactions. The nab-paclitaxel formulation eliminates the impact of Cremphor-EL on paclitaxel pharmacokinetics and utilizes the endogenous albumin transport mechanisms to. Hypersensitivity reactions (HSRs) to paclitaxel itself or its excipient, polyoxyethylated castor oil (Cremophor EL) initially occurred in up to 42% of patients. T This led to the routine use of prophylactic medications, including corticosteroids and histamine (H 1 and H 2) receptor antagonists before paclitaxel administration
These studies established that paclitaxel treatment induces hypersensitivity to noxious thermal stimulation, that is, thermal hyperalgesia in L3 larvae Mild hypersensitivity reactions were observed in 8 patients (7%) and all of these patients were successfully retreated with paclitaxel without HSRs. CONCLUSION: We conclude that this premedication and treatment strategy provides lower hypersensitivity reactions rate and allows for continuing administration of paclitaxel in patients with. OBJECTIVE: The aim of this study was to compare the rates of hypersensitivity reactions to paclitaxel with the conventional prophylactic regimen of two doses of oral corticosteroids and a modified regimen of a single dose of intravenous corticosteroid. METHODS: This was a retrospective historical cohort study assessing the rates of. For these reasons, nab-paclitaxel can be infused using higher doses of paclitaxel than that achievable with CrEL-paclitaxel, with shorter infusion duration and without the requirement for corticosteroid and anti-histamine pre-medication to reduce the risk of solvent-mediated hypersensitivity reactions (Gradishar, 2006)
Kwan noted that these AEs were expected based on what has been observed with paclitaxel. Notably, no hypersensitivity reactions were observed. 5 Oraxol also is under study for other malignancies, including gastric, gastroesophageal, and esophageal cancers in a phase I trial in combination with ramucirumab (Cyramza; NCT02970539). The drug. Patients with a history of bee-sting allergy may have a higher risk of a hypersensitivity reaction with paclitaxel treatment. We suggest careful screening of patients for allergies Learn more about dosing, efficacy, safety and patient financial info for ABRAXANE (paclitaxel protein-bound particles for injectable suspension) (albumin-bound). For U.S. healthcare providers only. See safety info + boxed warning on neutropenia Warning. Taxol ® (paclitaxel) should be administered under the supervision of a physician experienced in the use of cancer chemotherapeutic agents. Appropriate management of complications is possible only when adequate diagnostic and treatment facilities are readily available. Anaphylaxis and severe hypersensitivity reactions characterized by dyspnea and hypotension requiring treatment.
Hypersensitivity to carboplatin is rarely observed during the first course of treatment 4.3.2 If patients receiving weekly paclitaxel experience no hypersensitivity reactions after the first two doses, remove pre-medication with dexamethasone, chlorphenamine and H 2 antagonist from dose 3 onwards (off-label). Rationale: Although the product license states that patients on paclitaxel Apart from hypersensitivity reactions (allergic/immunologic reactions), the likelihood of paclitaxel related adverse events is low, due to the low exposure. There may be other potential adverse events that are unforeseen at this time of severe hypersensitivity reactions is not needed Potential Impact In metastatic breast cancer, nab-paclitaxel monotherapy may be used in place of paclitaxel monotherapy as second-line or greater therapy. The NCCN classifies the use of nab-paclitaxel as a Category 2A recommendation in this indication
The aim of this study was to describe a rapid retreatment strategy that is safe and cost effective in ovarian cancer patients with Taxol hypersensitivity reactions. Methods.A retrospective review of 91 women receiving Taxol-based chemotherapy at the University of Iowa Hospitals and Clinics between October 1991 and July 1996 was performed Abstract Background: Cancer patients treated with the anticancer drug, paclitaxel (Taxol) often experience mild to severe hypersensitivity reactions. It is not known how these reactions are induced and whether the inducer is paclitaxel or its vehicle (i.e., Cremophor EL in 50% ethanol) Paclitaxel Injection, USP is contraindicated in patients who have a history of hypersensitivity reactions to paclitaxel or other drugs formulated in Polyoxyl 35 Castor Oil, NF. Paclitaxel Injection, USP should not be used in patients with solid tumors who have baseline neutrophil counts of <1,500 cells/mm 3 or in patients with AIDS-related. Several risk factors, such as menopausal status, high BMI, history of hypersensitivity, and respiratory dysfunction, are recognized to predict the incidence of paclitaxel HSR in a subgroup of patients with gynecological cancers [1, 8]. Sendo et al. reported 4 risk factors associated with HSR: history of mild dermal reactions in previous courses. OBJECTIVE:To evaluate clinical literature supporting the prophylactic use of single-dose intravenous dexamethasone to prevent hypersensitivity reactions (HSRs) to paclitaxel infusion.DATA SOURCES:C..
Hypersensitivity reaction incidence and drug wastage cost were again assessed. RESULTS Before the routine use of a test dose, 162 patients received one or two paclitaxel infusions alone or in combination therapy from January 1, 1997 to February 28, 2003. Ten (6.2%) patients experienced a hypersensitivity reaction; one of them was severe One of the potentially serious and dose-limiting toxicities of paclitaxel is the development of hypersensitivity reactions (HSRs). Up to 42% of patients receiving paclitaxel experience an HSR, with serious (> grade 3) reactions observed in about 2% of patients SPR064 is a pro-drug of paclitaxel which has a much higher solubility as compared to the parent drug; hence, SPR064 can be conveniently formulated in non-cremapor based medium, reducing the risk of cremaphor-related hypersensitivity reactions.. Objective: To investigate the efficacy and safety of a nondilution, 1-bag protocol in comparison with a conventional multi-bag protocol for desensitization of patients with paclitaxel hypersensitivity. Methods: Patients who underwent paclitaxel desensitization between 2011 and 2018 were analyzed in this retrospective cohort study All rats in the SCS + paclitaxel (n = 11), Sham SCS + paclitaxel (n = 6), and paclitaxel only (n = 7) groups developed mechanical hypersensitivity by 1 week after the first paclitaxel dose, as indicated by the significant decrease in PWT from baseline
The reduction of SNAP amplitude induced by paclitaxel was also reversed by both fenofibrate and choline-fenofibrate. Our results indicate that suppression of paclitaxel-induced hypersensitivity by fibrates involves the regulation of PPAR-⍺ expression and decrease neuroinflammation in DRG Paclitaxel affected mitochondrial function and glutathione in DRG cells, which was abrogated by MitoVitE but not Trolox, without decreasing cancer cell cytotoxicity. In rats, paclitaxel-induced mechanical hypersensitivity was ameliorated by MitoVitE treatment to an extent similar to duloxetine PURPOSE: Paclitaxel-based chemotherapy continues to be an integral component of breast cancer treatment. Prolonged use of paclitaxel may result in repeate
Hypersensitivity to paclitaxel manifested as a bullous fixed drugeruption Nicole Lee Paclitaxel is the first of a new class of microtubule-stabilizing antitumor agents, with demonstrated activity against advanced and refractory ovarian, breast, lung, and head and neck cancers Hypersensitivity reactions consisted of isolated face flushes (3 patients), dyspnea and chest tightness (4 patients) or bronchospasm (5 patients). Eleven patients were rechallenged with the original paclitaxel solution starting at a slower rate after a second premedication with a double dosage of steroids Background: Immediate hypersensitivity reactions (IHRs) are commonly found in patients receiving paclitaxel. Effects of paclitaxel vary because of variable co-therapy or re-challenge with paclitaxel
Hypersensitivity reactions Early development of paclitaxel was hampered by the high incidence of major hypersensitivity reactions, which in some studies approached 30 percent. Initial observations.. 4.3.2 If patients receiving weekly paclitaxel experience no hypersensitivity reactions after the first two doses, remove pre-medication with dexamethasone, chlorphenamine and H 2 antagonist from dose 3 onwards (off-label) Hypersensitivity to PACLitaxel, trastuzumab or any of the excipients. Clinically significant cardiac disease. Baseline neutrophil count < 1.5 x 109/L Severe hepatic impairment PRESCRIPTIVE AUTHORITY: The treatment plan must be initiated by a Consultant Medical Oncologist. TESTS: Baseline tests: FBC, renal and liver profil Paclitaxel is one of the most extensively used anticancer agents, however, its use is often limited by severe hypersensitivity reactions, including respiratory distress, bronchospasm, and hypotension, which can occur despite premedication with dexamethasone and histamine H 1 and H 2 antagonists Such reactions are common during administration of paclitaxel, a taxane, and mild reactions are attributed to the vehicle (3 3. Weiss RB, Donehower RC, Wiernik PH, Ohnuma T, Gralla RJ, Trump DL, et al. Hypersensitivity reactions from taxol. J Clin Oncol. 1990;8:1263-8. [PMID: 1972736
Abraxane 260mg/m2 has a similar side-effect profile to standard paclitaxel 175mg/m.2, Hypersensitivity was not seen in the phase III study despite the lack of premedication and the reduced infusion time. H However, postmarketing surveillance from other countries has noted the rare incidence of severe hypersensitivity reactions The efficacy and tolerability of paclitaxel (Taxol) has been established through numerous phase II and III clinical trials that mostly evaluated doses ranging from 135 mg/m² to 250 mg/m² and infusion durations of 3, 24, or 96 hours TAXOL is contraindicated in patients who have a history of hypersensitivity reactions to TAXOL or other drugs formulated in Cremophor® EL (polyoxyethylated castor oil). TAXOL should not be used in patients with solid tumors who have baseline neutrophil counts of <1500 cells/mm3 or in patients with AIDS-related Kaposi's sarcoma with baseline. Gynecologic oncology OBJECTIVE Administration of paclitaxel is associated with hypersensitivity reactions (HSRs) in up to 9% of patients despite premedication To compare the efficacies and side effects of intravenous and oral dexamethasone (IV‐D and PO‐D) for paclitaxel‐associated hypersensitivity reaction (P‐HSR) prophylaxis in patients with primary ovarian, fallopian tube and peritoneal carcinomas (POC/PFTC/PPC) receiving a first cycle of paclitaxel plus carboplatin (TC)
Paclitaxel is an anti-microtubule agent which induces abnormal arrays or bundles of microtubules during the cell cycle and inhibits vital interphase and mitotic cellular functions In a study of hypersensitivity reactions to paclitaxel, 56% of patients reacted with the first dose, 41% with the second, and 3% with subsequent doses. 7 Moreover, patients with mild reactions often tolerate reinitiation of the infusion at a slower rate. 5 Nevertheless, it is standard to treat reactions to docetaxel similarly to histamine. Paclitaxel Hypersensitivity, hypotension, bradycardia, peripheral neuropathy, myalgia and back pain on administration The adverse effects listed are not exhaustive. Please refer to the relevant Summary of Product Characteristics for full details. Monitoring Regimen • FBC, U&E's and LFT's every 21 days starting from day one of cycle one
Hypersensitivity reactions (HSRs), though rare in response to anticancer agents, are caused by certain classes of agents including platinum agents (cisplatin, carboplatin, and oxaliplatin), taxanes (paclitaxel and docetaxel), procarbazine and asparaginase, and epipodophyllotoxins (teniposide and etoposide) [1-5].Despite comparatively lower frequency, doxorubicin and 6-mercaptopurine are also. However, the risk of developing a carboplatin hypersensitivity reaction is related to increased exposure to the drug, and peak incidence has been observed during cycle 2 of a patient's second course of carboplatin-based treatment View This Abstract Online; Prophylaxis for paclitaxel hypersensitivity reactions. Ann Pharmacother. 2001; 35(9):1114-7 (ISSN: 1060-0280). Kintzel PE. OBJECTIVE: To evaluate clinical literature supporting the prophylactic use of single-dose intravenous dexamethasone to prevent hypersensitivity reactions (HSRs) to paclitaxel infusion
Paclitaxel is contraindicated in patients who have a history of hypersensitivity reactions to paclitaxel or other drugs formulated in polyoxyl 35 castor oil. Paclitaxel should not be used in patients with solid tumors who have baseline neutrophil counts of <1,500 cells/mm 3 or in patients with AIDS-related Kaposi's sarcoma with baseline. . Severe and sometimes fatal hypersensitivity reactions. Cross-hypersensitivity between ABRAXANE and other taxanes has been reported Congestive heart failure, left ventricular dysfunction, and atrioventricular block
Paclitaxel is contraindicated in patients with severe hypersensitivity to paclitaxel or to any excipients listed in section 6.1, especially polyoxyethylated 35 castor oil (see section 4.4). Paclitaxel should not be used in patients with baseline neutrophils < 1,500/mm 3 (< 1,000/mm 3 for KS patients) at the start of therapy If no PACLitaxel hypersensitivity reactions occur, no premedications may be needed for subsequent Day 8 and 15 PACLitaxel doses and may be omitted at physician's discretion. NOTE: If no PACLitaxel hypersensitivity reactions occur, dexamethasone 8 mg PO may be given on Day 1 of each cycle (day of CARBOplatin treatment) in place of th
Breast -Paclitaxel (7 day) Administration Information • Hypersensitivity reactions tend to occur with the first or second infusion of paclitaxel. Paclitaxel infusion should be interrupted for minor symptoms such as flushing or localised rashes. If these resolve promptly (within 5 minutes The research demonstrated the effectiveness of albumin-bound paclitaxel, being the recommended dose defined as 260 mg/m2 of nanoparticle paclitaxel intravenously over 30 minutes every three weeks. Clinically important adverse events reported include neutropenia, anemia, infections, hypersensitivity reactions, sensory neuropathy, edema, nausea. Anaphylaxis and severe hypersensitivity reactions characterized by dyspnea and hypotension requiring treatment, angioedema, and generalized urticaria have occurred in 2 to 4% of patients receiving paclitaxel in clinical trials. Fatal reactions have occurred in patients despite premedication Anaphylaxis or significant hypersensitivity reaction is one of the most catastrophic potential complications of chemotherapy. There is a 2-5% risk of hypersensitivity with paclitaxel, a commonly used chemotherapeutic agent for various cancers. Three patients, who developed hypersensitivity to pacli The clinical spectrum of hypersensitivity reactions reported with paclitaxel has not included the occurrence of pulmonary infiltrates. This report describes three patients who developed transient pulmonary infiltrates after receiving paclitaxel. These infiltrates were noted 2 days to 2 weeks after administration of paclitaxel. The infiltrates resolved spontaneously in all the patients but one.
OBJECTIVE: Administration of paclitaxel is associated with hypersensitivity reactions (HSRs) in up to 9% of patients despite premedication. The purpose of this study was to evaluate the effectiveness of a standardized desensitization protocol in patients with HSRs to taxanes, based on our experience with carboplatin desensitization. METHODS: We analyzed seventeen consecutive patients with. Paclitaxel (taxol) is an anti-microtubule drug that is commonly used in the treatment of breast, ovarian and lung cancers. Common toxicities associated with paclitaxel include hypersensitivity reaction, peripheral neuropathy, myelotoxicity, and myalgia. DI-ILD (pneumonitis) is a very rare complication with paclitaxel Severe hypersensitivity reactions including dyspnea, flushing, chest pain, tachycardia, hypotension requiring treatment, angioedema, and generalized urticaria have occurred in patients receiving paclitaxel by i.v. administration. These reactions are probably histamine mediated
. Head and neck, breast, and lung cancer protocols were included One-Hour Paclitaxel Infusion/Hainsworth and Greco 1379 If any symptoms of severe acute hypersensitivity reac- tions occurred, the paclitaxel infusion was to be discon- tinued and standard treatment for anaphylaxis insti- tuted immediately. After paclitaxel administration, patients had com- plete blood counts checked weekly. Patients were eval
Cross-hypersensitivity between nab-paclitaxel and other taxane products has been reported and may include severe reactions such as anaphylaxis. The use of nab-paclitaxel in patients previously exhibiting hypersensitivity to paclitaxel injection or human albumin hypersensitivity has not been studied An allergic reaction also referred to as a hypersensitivity reaction is an overactive or misdirected immune response that results in local tissue injury or changes throughout the body in response to a foreign substance. These reactions can be caused by many factors, including chemo treatments. Our body's immune response to a foreign substance is potentially a two-edged sword it can either. How does paclitaxel work to treat cancer? Which phase of cell cycle does it work in? (Reference) 1. Microtubules; The basics Molecular biology of the cell 10.. . Markman M, Blessing J, Rubin SC, et al. Phase II trial of weekly paclitaxel (80 mg/m2) in platinum and paclitaxel-resistant ovarian and primary peritoneal cancers: a Gynecologic Oncology Group study Hypersensitivity to paclitaxel or to any of the excipients. Severe hepatic impairment. Baseline neutrophil count < 1,500 cells/mm3 (< 1,000 cells/mm3 for AIDS-KS). Concurrent, serious, uncontrolled infections. Pregnancy and lactation. 4.4 Special warnings and special precautions for us
Abstract. Support Care Cancer (2009) 17:1311-1315 DOI 10.1007/s00520-009-0588-4 ORIGINAL ARTICLE Retrospective evaluation of weekly paclitaxel hypersensitivity reactions reported utilizing an electronic medical record system at a tertiary cancer center Lincy S. Lal & Donna L. Gerber & Jason Lau & William Dana Received: 14 October 2008 /Accepted: 20 January 2009 /Published online: 30 January. Hypersensitivity reactions occurred in 4 of 13 (30.8%) BRCA-mutated patients and 22 of 49 (44.9%) BRCA wild-type patients (p = .5291). Hypersensitivity reactions to paclitaxel occurred in 1 of 13 (7.7%) BRCA-mutated patients and 26 of 49 (53.1%) BRCA wild-type patients (p = .0039). Overall, there were 11 grade 1 reactions, 14 grade 2 reactions. - Hypersensitivity reaction and neuropathy * mPEG-PDLLA: monomethoxy-poly (ethylene glycol)-block-poly(D,L-lactide) More than a dozen studies have been completed to attest to the safety and efficacy of Genexol Dose-dense paclitaxel (Genexol.
. By day 14, significant mechanical/cold hypersensitivity was observed, which then increased to a peak approximately one month after the first paclitaxel injection Paclitaxel hypersensitivity manifestations?? Dyspnea, flushing, chest pain and tachycardia were the most frequent manifestations. why does hypersensitivity occur with paclitaxel? May be caused by histamine release mediated by the Cremophor EL diluent. When does myalgias appear with paclitaxel adm Substituted for either paclitaxel or docetaxel in persons who have experienced hypersensitivity reactions after receiving paclitaxel or docetaxel despite premedication, or for persons in whom standard hypersensitivity pre-medications are contraindicated . Continued on next page