title: Hypersensitivity reactions to docetaxel: retrospective evaluation and development of a desensitization protocol.
abstract: BACKGROUND
  Docetaxel (DT) is an extensively used taxane, frequently associated with hypersensitivity reactions. The aim of this study was to record the epidemiological and clinical features of hypersensitivity to DT in non-small cell lung cancer patients in order to obtain useful information concerning the management of these patients. We also developed a desensitization protocol and evaluated its clinical application.
  
  
  METHODS
  We retrospectively reviewed records of 620 non-small cell lung cancer patients treated with DT-containing regimens in the adjuvant, first-, second- or next-line setting. Data from 102 patients who had exhibited hypersensitivity reactions were analyzed according to the Common Toxicity Criteria for Adverse Events version 3.0. Five patients were chosen for the desensitization protocol. We applied the standard protocol for parenteral desensitization to β-lactam antibiotics, and DT treatment was carried out with a series of 10-fold dilutions in sufficient volume to administer the total dose.
  
  
  RESULTS
  One hundred and two patients (16.5%) were recorded as having hypersensitivity to DT. Reactions were observed after approximately 2.5 ± 1.0 cycles. Only 14 patients (14/620, 2%) developed grade 3-4 hypersensitivity. Reactions were more likely in patients during second- or third-line chemotherapy, but no other correlation (age, gender, atopic status) was observed. Five patients completed a parenteral desensitization protocol and continued their treatment uneventfully.
  
  
  CONCLUSIONS
  Hypersensitivity reactions to DT respond quickly to discontinuation along with appropriate supportive care. Premedication and increased infusion time may allow readministration. The desensitization protocol that we developed provides a reliable alternative to permanent discontinuation of DT.
authors: Oncology Unit, Third Department of Medicine, Sotiria General Hospital, Athens Medical School, Athens, Greece.
authors: Ekaterini
authors: E
authors: Syrigou
authors: Ioannis
authors: I
authors: Dannos
authors: Elias
authors: E
authors: Kotteas
authors: Nektaria
authors: N
authors: Makrilia
authors: Ioannis
authors: I
authors: Tourkantonis
authors: Kalliopi
authors: K
authors: Dilana
authors: Ioannis
authors: I
authors: Gkiozos
authors: Muhammad Wasif
authors: MW
authors: Saif
authors: Kostas N
authors: KN
authors: Syrigos
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods*; D000077143:Docetaxel; D004342:Drug Hypersensitivity / Q000276:immunology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D043823:Taxoids / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel