Use of Docetaxel After Paclitaxel Hypersensitivity Reaction in Epithelial Ovarian and Endometrial Cancer


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Abstract

AbstractObjective:The purpose of this study was to evaluate the results of substituting docetaxel for paclitaxel in women who experienced a paclitaxel-associated hypersensitivity reaction while undergoing chemotherapy for ovarian and endometrial cancer.Patients and Methods:Reviewing a comprehensive data file, we identified all epithelial ovarian cancer and primary endometrial cancer patients who experienced a documented significant hypersensitivity reaction to paclitaxel and were subsequently treated with docetaxel at our university hospital from March 2004 to August 2008.Results:We identified a total of 11 patients who met inclusion criteria of hypersensitivity reaction after paclitaxel injection. Ten cases were noted as mild reactions, and one case presented severe reaction of anaphylaxis; all patients showed cutaneous manifestations, and 3 patients complained of transient palpitation (27.3%). Nine cases (81.8%) were arising in 36 ovarian cancer patients (25%), and 2 were arising in 22 endometrial cancer patients (9.1%). The mean number of cycles hypersensitivity reaction appeared was 1.6 cycles. Two cases discontinued further therapy with taxanes. Nine of 11 cases rechallenged with docetaxel for the replacement of paclitaxel within 3 days after hypersensitivity reaction appeared, and 8 of them well tolerated docetaxel without any reactions. One of them showed cross-reaction to docetaxel and discontinued therapy with taxanes. All residual 8 patients completed due course of taxane-based chemotherapy.Conclusion:The use of docetaxel is a reasonable approach for continuing taxane-based chemotherapy in patients with a paclitaxel hypersensitivity reaction. Mild hypersensitivity reaction to paclitaxel could be the predicting sign for replacement with docetaxel, and early rechallenging with docetaxel is suggested for subsequent successful infusion.

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