title: Administration of cisplatin in three patients with carboplatin hypersensitivity: is skin testing useful?
abstract: Carboplatin is a chemotherapeutic agent approved in the first-line setting of numerous malignancies. Hypersensitivity to carboplatin has been reported in up to 44% of patients receiving this antineoplastic agent, usually occurring after several courses of treatment. The aim of this study was to determine the usefulness of skin tests in ruling out cross-reaction to cisplatin to continue platinum-based chemotherapy in patients who are responsive to these agents. Prick tests and intradermal tests with a series of dilutions of carboplatin and cisplatin were performed on three patients who had exhibited medium and severe hypersensitivity reactions to carboplatin. Prick tests were negative in both the antineoplastic agents. Intradermal tests with carboplatin were positive in all three patients and negative with cisplatin. In all patients, the administration of cisplatin instead of carboplatin was well tolerated without the need of premedication. In conclusion, intradermal skin tests can be a useful tool for detecting a potential cross-reaction between platinum salts. It allows safe administration of a different platinum agent in patients who seem to benefit from platinum-based therapy. Discontinuation of chemotherapy, desensitization protocols and steroid premedication can be avoided.
authors.affiliation: Oncology Unit, Third Department of Medicine, Sotiria General Hospital, Athens School of Medicine, Athens, Greece.
authors.forename: Ekaterini
authors.initials: E
authors.lastname: Syrigou
authors.forename: Nektaria
authors.initials: N
authors.lastname: Makrilia
authors.forename: Antonios
authors.initials: A
authors.lastname: Vassias
authors.forename: Ilias
authors.initials: I
authors.lastname: Nikolaidis
authors.forename: Vassilia
authors.initials: V
authors.lastname: Xyla
authors.forename: Leonidas
authors.initials: L
authors.lastname: Manolopoulos
authors.forename: Kostas
authors.initials: K
authors.lastname: Syrigos
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000188:drug therapy; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E; D007428:Intradermal Tests; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy; D012882:Skin Tests
chemical_list: D000970:Antineoplastic Agents; D007073:Immunoglobulin E; D016190:Carboplatin; D002945:Cisplatin