Chemotherapy
Clinical Study
Tapering and Discontinuation of Glucocorticoid Prophylaxis during Prolonged Weekly to Biweekly Paclitaxel AdministrationBraverman A.S. · Rao S. · Salvatti M.E. · Adamson B. · McManus M. · Pierre S.Downstate College of Medicine, State University of New York, New York, N.Y., USA
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: November 19, 2004
Accepted: November 21, 2004
Published online: June 03, 2005
Issue release date: May 2005
Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 4
ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)
For additional information: https://www.karger.com/CHE
Abstract
Background: Taxanes cause hypersensitivity reactions, averted by premedication with H1 blockers and high glucocorticoid (GC) doses. Prolonged weekly taxane administration may lead to GC toxicity. Purpose: To determine whether patients not hypersensitive to initial paclitaxel (PTX) infusion after high-dose GC premedication will tolerate subsequent, prolonged PTX treatment without GC prophylaxis. Patients and Methods: In 115/122 breast cancer patients not hypersensitive to initial PTX treatment, 20 mg dexamethasone (DXM) doses were tapered by 2.0 mg/week, reaching 0 in those receiving 9 or more courses. After 4 PTX courses, diphenhydramine was administered orally, rather than intravenously. Results: PTX was administered 143 times after 2.0–5.0 mg of DXM and 357 times without DXM. A total of 46 patients received 1–40 PTX courses without DXM. None of these 115 patients experienced hypersensitivity reactions. Conclusion: Patients unreactive to their first PTX infusions, after high-dose and tapering GC premedication, may not require GC prophylaxis for subsequent PTX therapy.
© 2005 S. Karger AG, Basel
Related Articles:
References
- Seidman AD, Hudis CA, Albanel J, Tong W, Tepler I, Currie V, Moynahan ME, Theodoulou M, Gollub M, Baselga J, Norton L: Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer. J Clin Oncol 1998;16:3353–3361.
- Weiss RB, Donehower RC, Wiernik PH, Ohnuma T, Gralla RJ, Trump DL, Baker JR Jr, Van Echo DA, Von Hoff DD, Leyland-Jones B: Hypersensitivity reactions from taxol. J Clin Oncol 1990;8:1263–1268.
- Markman M, Kennedy A, Webster K, Kulp B, Peterson G, Belinson J: Paclitaxel-associated hypersensitivity reactions: Experience of the gynecologic oncology program of the Cleveland Clinic Cancer Center. J Clin Oncol 2000;18:102–105.
- Gennari A, Salvadori B, Tognoni A, Conte PF: Rapid intravenous premedication with dexamethasone prevents hypersensitivity reactions to paclitaxel. Ann Oncol 1996;7:978–979.
- Boehm DK, Maksymuik AW: Paclitaxel premedication regimens. J Natl Cancer Inst 1996;88:463–464.
- Bookman MA, Kloth DD, Kover PE, Smolinski S, Ozols RF: Short-course intravenous prophylaxis for paclitaxel-related hypersensitivity reactions. Ann Oncol 1997;8:611–614.
- Micha JP, Rettenmaier MA, Dillman R, Fraser P, Birk C, Brown JV: Single-dose dexamethasone paclitaxel premedication. Gynecol Oncol 1998;69:122–124.
- Markman M, Kennedy A, Webster K, Peterson G, Kulp B, Belinson J: An effective and more convenient drug regimen for prophylaxis against paclitaxel-associated hypersensitivity reactions. J Cancer Res Clin Oncol 1999;125:427–429.
- Robinson JB, Singh D, Bodurka-Bevers DC, Wharton JT, Gershenson DM, Wolf JK: Hypersensitivity reactions and the utility of oral and intravenous desensitization in patients with gynecologic malignancies. Gynecol Oncol 2001;82:550–558.
- Kwon JS, Elit L, Finn M, Hirte H, Mazurka J, Moens F, Trin K: A comparison of two prophylactic regimens for hypersensitivity reactions to paclitaxel. Gynecol Oncol 2002;84:420–425.
- Koppler H, Heymanns J, Weide R: Dose reduction of steroid premedication for paclitaxel: No increase of hypersensitivity reactions. Onkologie 2001;3:283–285.
- Quock J, Dea G, Tanaka M, Gandara D, Lara P, Lau D: Premedication strategy for weekly paclitaxel. Cancer Invest 2002;20:666–672.
- Leyland-Jones B, Gelmon K, Ayoub JP, Arnold A, Verma S, Diss R, Ghahramani P: Pharmacokinetics, safety and efficacy of trastuzumab administered every 3 weeks in combination with paclitaxel. J Clin Oncol 2003;21:3965–3971.
-
Lewis T, DiMaio T, Patel N, Weedon J, Braverman A: Weekly paclitaxel as neoadjuvant therapy for patients with T3 and T4 breast cancers: A high incidence of complete responses. Proc Am Soc Clin Oncol 2002;21:70a.
- Peereboom DM, Donehower RC, Eisenhauer EA, McGuire WP, Onetto N, Hubbard JL, Piccart M, Gianni L, Rowinsky EK: Successful re-treatment with taxol after major hypersensitivity reactions. J Clin Oncol 1993;11:885–890.
- Essayan DM, Kagey-Sobotka A, Colarusso PJ, Lichtenstein LM, Ozols RF, King ED: Successful parenteral desensitization to paclitaxel. J Allergy Clin Immunol 1996;97:42–46.
- Henderson CI, Berry DA, Demetri GD, Cirricione CT, Goldstein LJ, Martino S, Ingle JN, Cooper MR, Hayes DF, Tkaczuk KH, Fleming G, Holland JF, Duggan DB, Carpenter JT, Frei E 3rd, Schilsky RL, Wood W, Muss HB, Norton L: Improved outcomes from adding sequential paclitaxel but not from escalating doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol 2003;21:976–983.
Article / Publication Details
Received: November 19, 2004
Accepted: November 21, 2004
Published online: June 03, 2005
Issue release date: May 2005
Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 4
ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)
For additional information: https://www.karger.com/CHE
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
