title: Use of cisplatin without desensitization after carboplatin hypersensitivity reaction in epithelial ovarian and primary peritoneal cancer.
abstract: 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.
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA 22908, USA.
authors: Megan B
authors: MB
authors: Callahan
authors: Jason A
authors: JA
authors: Lachance
authors: Rebecca L
authors: RL
authors: Stone
authors: Julie
authors: J
authors: Kelsey
authors: Laurel W
authors: LW
authors: Rice
authors: Amir A
authors: AA
authors: Jazaeri
mesh_terms: 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*
chemical_list: D016190:Carboplatin; D002945:Cisplatin