Carboplatin Hypersensitivity Reactions: Re-treatment with Cisplatin Desensitisation

Objective: This aim of this study was to investigate the feasibility of re-treating patients who had experienced a hypersensitivity reaction to carboplatin with cisplatin following desensitisation.

Methods: Five patients with recurrent ovarian cancer who had a previous documented hypersensitivity reaction to carboplatin and a good clinical indication for continuing treatment with platinum were retreated following cisplatin desensitisation. All patients were rechallenged with cisplatin following a prolonged desensitisation protocol and the initial four patients then received subsequent cycles with a shortened protocol in an attempt to simplify and shorten the procedure.

Results: All five patients tolerated their first cycle of cisplatin on rechallenge using the full desensitisation protocol with no adverse reactions. Two patients received further treatments (one and three cycles) with a shortened protocol but treatment was terminated due to further adverse hypersensitivity reactions. Two patients received one further cycle with a shortened protocol and did not experience problems with hypersensitivity but treatment was stopped due to evidence of disease progression One patient received a further two cycles using the full desensitisation protocol without problems but treatment was stopped due to evidence of disease progression.

Conclusions: A full cisplatin desensitisation protocol appears to be an effective way to re-treat patients who have previously experienced a hypersensitivity reaction to carboplatin. Attempts to shorten the procedure were associated with further allergic reactions, suggesting that the full protocol should be followed with each treatment.