title: Adverse events to nontargeted and targeted chemotherapeutic agents: emphasis on hypersensitivity responses.
abstract: Use of cytotoxic agents is associated with potential hypersensitivity reactions which are common with platinum compounds, L-asparaginase, taxanes, procarbazine and epipodophyllotoxins. Mechanisms underlying the reactions may involve IgE, non-allergic or a number of pathogenetically unclear events. Targeted therapies produce less collateral damage but demonstrate their own unique reactions. Cytopenias occur less often and mucocutaneous reactions to EGFR inhibitors, including papulopustular rash, are common. Fifteen currently approved mAbs provoke all four types of hypersensitivities including immune cytopenias, vasculitis, serum sickness and pulmonary events. Some successful desensitization protocols have been developed. Prevention of hypersensitivity reactions is based on skin testing, premedication and/or desensitization.
authors.affiliation: Molecular Immunology Unit, Kolling Institute of Medical Research, Royal North Shore Hospital of Sydney, Sydney 2065, Australia; Department of Medicine, University of Sydney, Sydney 2006, Australia. Electronic address: babaldo@iinet.net.au.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Baldo
authors.affiliation: Medicine Department, Pieve di Coriano Hospital, Azienda Ospedaliera C.Poma, Mantova, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Pagani
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000145:classification; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D011292:Premedication; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents
keywords: Adverse events to cancer drugs; Cancer drug hypersensitivities; Chemotherapeutic drug hypersensitivities; Desensitization to cancer drugs; Diagnosis of chemotherapeutic drug hypersensitivities; Monoclonal antibody adverse events; Monoclonal antibody hypersensitivities; Side effects of chemotherapeutic drugs