title: Feasibility of stopping paclitaxel premedication after two doses in patients not experiencing a previous infusion hypersensitivity reaction.
abstract: OBJECTIVE
  Paclitaxel-based chemotherapy continues to be an integral component in the treatment of many solid tumors. Prolonged use of paclitaxel may result in repeated doses of premedications and potential unwanted side effects. Infusion hypersensitivity reactions occurring beyond the second dose are infrequent and not well characterized. We hypothesized that patients whose paclitaxel premedications were discontinued after two doses were unlikely to experience infusion hypersensitivity reactions with subsequent paclitaxel doses.
  
  
  METHODS
  Patients receiving paclitaxel-based chemotherapy who did not experience an infusion hypersensitivity reaction with their first or second dose had their paclitaxel premedications discontinued. The primary endpoint was to estimate the incidence of rescue medication for the treatment of paclitaxel infusion hypersensitivity during doses 3 to 6 for patients whose paclitaxel premedications had been discontinued.
  
  
  RESULTS
  After receiving the first two doses of paclitaxel-based chemotherapy without experiencing an infusion hypersensitivity reaction (any grade), 55 breast cancer patients had their premedications discontinued for all remaining paclitaxel doses. None of these patients required rescue medication to treat an infusion hypersensitivity reaction with subsequent doses.
  
  
  CONCLUSIONS
  In patients who have not experienced an infusion hypersensitivity reaction with the first two doses of paclitaxel, discontinuation of paclitaxel premedications may be considered an option without an increased risk of infusion hypersensitivity requiring rescue medication.
authors.affiliation: Pharmacy Department, The James Comprehensive Breast Center, The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University, Columbus, OH 43212, USA. michael.berger@osumc.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Berger
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Dunlea
authors.forename: Amy E
authors.initials: AE
authors.lastname: Rettig
authors.forename: Maryam B
authors.initials: MB
authors.lastname: Lustberg
authors.forename: Gary S
authors.initials: GS
authors.lastname: Phillips
authors.forename: Charles L
authors.initials: CL
authors.lastname: Shapiro
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D003907:Dexamethasone / Q000008:administration & dosage; D004342:Drug Hypersensitivity / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D005938:Glucocorticoids / Q000008:administration & dosage; D006633:Histamine Antagonists / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D011292:Premedication; D014481:United States; D028761:Withholding Treatment
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D005938:Glucocorticoids; D006633:Histamine Antagonists; D003907:Dexamethasone; D017239:Paclitaxel
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