Claire M Mach1, Elisabeth A Lapp2, Kellie J Weddle3, Rodney J Hunter4,5, Kimberly A Burns6, Crystal Parker7, Jubilee Brown6, Judith A Smith1,4,5,8. 1. Department of Clinical Pharmacy and Administration, University of Houston, College of Pharmacy, Houston, Texas. 2. University of Incarnate Word, Feik School of Pharmacy, San Antonio, Texas. 3. Department of Pharmacy Practice, Purdue University, West Lafayette, Indiana. 4. Department of Pharmacy Practice, Texas Southern University, College of Pharmacy and Health Sciences, Houston, Texas. 5. Department of Pharmacy, Memorial Hermann Hospital-UTHealth Cancer Center-TMC, Houston, Texas. 6. Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas. 7. Department of Biostatistics and Applied Mathematics, The University of Texas M.D. Anderson Cancer Center, Houston, Texas. 8. Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center, Houston, Texas.
Abstract
OBJECTIVE: The objective of this study was to evaluate the impact of premedications given as an adjunct to carboplatin on the incidence of hypersensitivity reactions in women with ovarian cancer. Medications of interest include a histamine1 (H1 ) and histamine2 (H2 ) blocker in addition to dexamethasone. METHODS: This was a retrospective chart review evaluating the addition of an H1 and H2 blocker in addition to dexamethasone as standard premedications on the incidence of carboplatin hypersensitivity reactions (CHRs) in women with ovarian cancer. MAIN RESULTS: The odds ratio for premedication use was 0.46 with a 95% confidence interval (0.17-1.27), suggesting that patients with premedication use had approximately half the risk of CHR compared with patients without premedication. The overall incidence of CHRs decreased from 7.9% at baseline to 3.2% after the addition of premedications. The incidence of CHRs was 5.2% in 58 patients with recurrent or progressive disease compared with 2.1% in 96 newly diagnosed patients. Lifetime dose greater than 3377 mg, number of cycles more than six, and progressive or recurrent disease were predictive factors of CHR in women with ovarian cancer. PRINCIPAL CONCLUSIONS: Total lifetime exposure to carboplatin remains the greatest predictive factor of CHR in women with ovarian cancer. Although data analysis indicates the addition of premedications for all ovarian cancer patients receiving carboplatin did not result in a statistically significant reduction in CHRs, a patient benefit in CHR reduction was observed. A prospective study is needed to confirm these findings.
OBJECTIVE: The objective of this study was to evaluate the impact of premedications given as an adjunct to carboplatin on the incidence of hypersensitivity reactions in women with ovarian cancer. Medications of interest include a histamine1 (H1 ) and histamine2 (H2 ) blocker in addition to dexamethasone. METHODS: This was a retrospective chart review evaluating the addition of an H1 and H2 blocker in addition to dexamethasone as standard premedications on the incidence of carboplatinhypersensitivity reactions (CHRs) in women with ovarian cancer. MAIN RESULTS: The odds ratio for premedication use was 0.46 with a 95% confidence interval (0.17-1.27), suggesting that patients with premedication use had approximately half the risk of CHR compared with patients without premedication. The overall incidence of CHRs decreased from 7.9% at baseline to 3.2% after the addition of premedications. The incidence of CHRs was 5.2% in 58 patients with recurrent or progressive disease compared with 2.1% in 96 newly diagnosed patients. Lifetime dose greater than 3377 mg, number of cycles more than six, and progressive or recurrent disease were predictive factors of CHR in women with ovarian cancer. PRINCIPAL CONCLUSIONS: Total lifetime exposure to carboplatin remains the greatest predictive factor of CHR in women with ovarian cancer. Although data analysis indicates the addition of premedications for all ovarian cancerpatients receiving carboplatin did not result in a statistically significant reduction in CHRs, a patient benefit in CHR reduction was observed. A prospective study is needed to confirm these findings.
Authors: Katherine LaVigne; David M Hyman; Qin C Zhou; Alexia Iasonos; William P Tew; Carol Aghajanian; Vicky Makker; Martee L Hensley; Jason Konner; Rachel N Grisham; Nicholas Cangemi; Krysten Soldan; David R Spriggs; Paul J Sabbatini; Roisin E OʼCearbhaill Journal: Int J Gynecol Cancer Date: 2018-07 Impact factor: 3.437