Use of cisplatin without desensitization after carboplatin hypersensitivity reaction in epithelial ovarian and primary peritoneal cancer.
OBJECTIVE
The purpose of this study was to evaluate the results of substituting cisplatin for carboplatin in women who experienced a carboplatin-associated hypersensitivity reaction while undergoing treatment for gynecologic cancers.


METHODS
Using a comprehensive data repository, we identified all epithelial ovarian cancer and primary peritoneal cancer patients who experienced a documented significant hypersensitivity reaction to carboplatin and were subsequently treated with cisplatin at our institution from 1995 to the present. We also performed a review of published case reports of similar patient management.


RESULTS
We identified a total of 24 patients who met inclusion criteria. Eighteen patients (75%) tolerated cisplatin without any adverse events. Six patients (25%) eventually developed a reaction to cisplatin; none was life threatening, and only 1 required hospitalization. Twenty-three of the 24 patients (96%) tolerated at least 1 cycle of cisplatin. Of the 5 patients who initially tolerated cisplatin but eventually experienced a reaction, the mean number of cycles tolerated was 3.4.


CONCLUSIONS
The use of cisplatin without desensitization is a reasonable approach for continuing platinum-based chemotherapy in patients with a significant carboplatin hypersensitivity reaction. Patients should be advised of risks and closely monitored, given published case reports of anaphylaxis.
Callahan
Megan B
MB
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA.
Lachance
Jason A
JA
Stone
Rebecca L
RL
Kelsey
Julie
J
Rice
Laurel W
LW
Jazaeri
Amir A
AA
D000328:Adult; D000368:Aged; D016190:Carboplatin / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D004342:Drug Hypersensitivity / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D010534:Peritoneal Neoplasms / Q000188:drug therapy*
D016190:Carboplatin; D002945:Cisplatin