title: Effect of Prophylactic Extended-Infusion Carboplatin on Incidence of Hypersensitivity Reactions in Patients with Ovarian, Fallopian Tube, or Peritoneal Carcinomas.
abstract: To determine whether extended-infusion carboplatin, initiated at approximately the eighth cumulative carboplatin cycle and prior to development of carboplatin hypersensitivity, reduces the incidence of carboplatin hypersensitivity reactions in patients with ovarian, fallopian tube, or peritoneal cancer.
  
  
  
  Retrospective chart review.
  
  
  
  Large integrated health system.
  
  
  
  A total of 326 patients with ovarian, fallopian tube, or primary peritoneal cancer who received at least eight cumulative cycles of carboplatin between January 2007 and September 2014 were included. Of these, 161 patients received all doses of carboplatin infused over 30 or 60 minutes (standard-infusion group [total of 1317 carboplatin cycles]), and 165 patients received the 3-hour extended infusion of carboplatin administered at approximately the eighth cumulative cycle and prior to development of a hypersensitivity reaction (extended-infusion group [total of 1527 carboplatin cycles]).
  
  
  
  Baseline characteristics were similar between the groups, except significantly more patients in the extended-infusion group received triple premedication therapy prior to infusion (p<0.001). Hypersensitivity reactions occurred in 64 patients (40%) who received standard-infusion carboplatin and 40 patients (24.2%) who received extended-infusion carboplatin (p=0.0027). The median cycle of hypersensitivity reaction development did not differ significantly between the groups: 9 cycles in patients who received standard-infusion versus 11 cycles in patients who received extended-infusion carboplatin (p=0.06). Through regression analysis, the premedication regimen received prior to carboplatin infusion was the only variable significantly associated with hypersensitivity reactions (odds ratio 0.59, 95% confidence interval 0.36-0.97, p=0.038).
  
  
  
  Patients who received extended-infusion carboplatin experienced a lower incidence of hypersensitivity reactions than patients who received standard-infusion carboplatin, which may be attributed to the triple premedication regimen received more frequently in patients in the extended-infusion group.
authors.affiliation: Department of Pharmacy, Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Pasternak
authors.affiliation: Department of Pharmacy, Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Link
authors.affiliation: Department of Pharmacy, Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Richardson
authors.affiliation: Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Rose
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage* / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000453:epidemiology*; D005185:Fallopian Tube Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D010534:Peritoneal Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin
keywords: carboplatin; hypersensitivity reaction; ovarian cancer