P3-1-4SAFETY PROFILE OF THE DESENSITIZING CARBOPLATIN INFUSION FOR PATIENTS DOCUMENTED CARBOPLATIN HYPERSENSITIVITY

Abstract Background: The combination of carboplatin and other cytotoxic drug is the current standard chemotherapy regimen for platinum sensitive recurrent epithelial ovarian, and peritoneal cancer. Hypersensitivity reaction (HSR) is one of adverse events of platinum agents. Because repeated exposure to platinum agents, particularly carboplatin, is associated with development of HSR, it is often difficult to use continuous platinum combination therapy. On the other hands, Peter G Rose et al. had reported successful administration of carboplatin with desensitizing method for clinically documented carboplatin HSR. This report aims to assess the safety of the carboplatin desensitizing therapy through the analysis in single institution. Method: We reviewed medical record, and evaluated the safety profile of the carboplatin desensitizing therapy for the patients with platinum sensitive recurrent epithelial ovarian, and peritoneal cancer, who had history of HSR of carboplatin. The carboplatin dose was administrated with 1/1000th of the total carboplatin dose infused 60min in turn was followed by 1/100th and 1/10th infused 60min. The remaining dose was infused 2h. Patients were pretreated with 20mg intravenous dexamethasone prior to the initiation of carboplatin. Results: Between Feb 2012 and Jan 2014, 14 patients whose First HSR had occurred median 17 courses (range 8-43); Grade 1 8%, Grade 2 25%, Grade 3 33%, Grade 4 33%, received total 72 courses of carboplatin contained regimen. 9 patient, 59 courses were successfully rechallenged while 5 patients, 13 coarses had a recurrent carboplatin hypersensitivity; Grade 1 8%, Grade 2 8%, Grade 3 2%. All cases in which HSR recurred were handled with termination of the carboplatin infusion, followed by intravenous steroids and antihistamines with successful resolution, and were able to completely administrate carboplatin with slow infusion. Conclusion: A CBDCA desensitizing carboplatin infusion regimen is safe and well tolerated.