Johana Pradelli1, Paul Verdoire1, Jacques Boutros1, Anne-Claire Frin2, Philippe Follana3, Julien Duquesne4, Charles-Hugo Marquette5, Jonathan Benzaquen5, Michèle Ben Hayoun1, Sylvie Leroy6. 1. Department of Pulmonary Medicine and Allergology, CHU de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France. 2. Department of Gastroenterology, CHU de Nice, Université Côte d'Azur, Nice, France. 3. Department of Oncology, Centre Antoine Lacassagne, Nice, France. 4. Department of Pharmacology, CHU de Nice, Université Côte d'Azur, Nice, France. 5. Department of Pulmonary Medicine and Allergology, CHU de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France; IRCAN, Inserm U1081/CNRS 7284, FHU OncoAge, Université Côte d'Azur, Nice, France. 6. Department of Pulmonary Medicine and Allergology, CHU de Nice, FHU OncoAge, Université Côte d'Azur, Nice, France; Institut de Pharmacologie Moléculaire et Cellulaire, CNRS UMR 7275, Université Côte d'Azur, Sophia Antipolis, Nice, France. Electronic address: leroy.s2@chu-nice.fr.
Abstract
BACKGROUND: Hypersensitivity reactions (HSRs) to platinum salts (PS) and taxanes (TX) are a challenge to cancer management. Allergy evaluation based on skin tests (ST) and graded challenges can provide a diagnosis of an allergy to a suspected drug and indicate possible treatment with alternative same-class drugs. OBJECTIVE: This study aimed to estimate the negative predictive value of ST in the diagnosis of HSRs to TX and PS. METHODS: This multicenter study prospectively enrolled patients with a suspected HSR to PS and TX. ST were performed for chemotherapy, drugs of the same pharmacological class, and other agents (latex or cotreatments). For patients with negative ST, a graded challenge was performed by the cancer teams trained in allergy management. RESULTS: A total of 119 consecutive patients were included during a 6-year period. ST results were positive for 58% of the cohort: for TX in 7 patients and for PS in 62 patients. Other agents were responsible for 4.2% of cases. Skin cross-reactivity was 50% for TX and 30% for PS. A graded challenge was performed in 14 patients for TX and in 50 patients for PS. Negative predictive values (NPVs) for ST were 100% for TX and 92% for PS, with NPVs for individuals PS of 100% for cisplatin, 89% for oxaliplatin, and 87% for carboplatin. CONCLUSIONS: ST to PS or TX offered a high NPV, making allergy evaluation a key element in the management of patients with cancer. Graded challenges can be safely performed by oncology teams trained in anaphylaxis management.
BACKGROUND:Hypersensitivity reactions (HSRs) to platinum salts (PS) and taxanes (TX) are a challenge to cancer management. Allergy evaluation based on skin tests (ST) and graded challenges can provide a diagnosis of an allergy to a suspected drug and indicate possible treatment with alternative same-class drugs. OBJECTIVE: This study aimed to estimate the negative predictive value of ST in the diagnosis of HSRs to TX and PS. METHODS: This multicenter study prospectively enrolled patients with a suspected HSR to PS and TX. ST were performed for chemotherapy, drugs of the same pharmacological class, and other agents (latex or cotreatments). For patients with negative ST, a graded challenge was performed by the cancer teams trained in allergy management. RESULTS: A total of 119 consecutive patients were included during a 6-year period. ST results were positive for 58% of the cohort: for TX in 7 patients and for PS in 62 patients. Other agents were responsible for 4.2% of cases. Skin cross-reactivity was 50% for TX and 30% for PS. A graded challenge was performed in 14 patients for TX and in 50 patients for PS. Negative predictive values (NPVs) for ST were 100% for TX and 92% for PS, with NPVs for individuals PS of 100% for cisplatin, 89% for oxaliplatin, and 87% for carboplatin. CONCLUSIONS: ST to PS or TX offered a high NPV, making allergy evaluation a key element in the management of patients with cancer. Graded challenges can be safely performed by oncology teams trained in anaphylaxis management.
Authors: Faisal ALMuhizi; Leticia De Las Vecillas Sanchez; Lucy Gilbert; Ana M Copaescu; Ghislaine A C Isabwe Journal: Clin Rev Allergy Immunol Date: 2022-03-08 Impact factor: 8.667
Authors: José Ferreira Pires-Júnior; Tânia Couto Machado Chianca; Eline Lima Borges; Cissa Azevedo; Giovana Paula Rezende Simino Journal: Rev Lat Am Enfermagem Date: 2021-11-08