Hypersensitivity reactions to oxaliplatin: Can patients be rechallenged?

Abstract Background: The use of oxaliplatin is increasing in colorectal cancer both in the metastatic and adjuvant setting. There is an increased recognition of hypersensitivity reactions (HSR) to oxaliplatin which is a potential barrier to the continued use of this drug in patients in whom benefits are observed. The aim of this retrospective review is to identify the incidence of HSR and the results of rechallenging patients with oxaliplatin. Methods and results: In 97 patients, we identified six patients with HSR (an incidence of 6.2%) There was a spectrum of reported symptoms with most occurring within minutes of infusion after a median of six doses of oxaliplatin. All these patients were rechallenged with oxaliplatin. Success was noted when oxaliplatin was administered over a prolonged rate of 6 h. The use of maximal premedications did not influence the outcome. Conclusions: Our experience confirms the need to be vigilant of HSR to oxaliplatin and to recognize idiosyncratic reactions. A feasible method to prevent the recurrence of HSR is to prolong the infusion rate without delaying or stopping effective treatment with oxaliplatin.