Carboplatin/dexamethasone

Abstract

Hypersensitivity/diabetes mellitus: case report A 47-year-old woman developed hypersensitivity and diabetes mellitus during treatment with carboplatin and dexamethasone, respectively [routes, dosages, durations of treatments to reactions onsets and outcomes not stated]. The woman presented to hospital in Canada in November 2016 with abdominal pain, distension, and weight loss. In October 2016, a confirmed diagnosis of high grade serous carcinoma, likely ovarian origin was made. In December 2016, a primary debulking surgery was attempted, but aborted due to the extent of disease intraoperatively, and she underwent omentectomy to confirm the diagnosis. Later, she received 4 cycles of neoadjuvant carboplatin and paclitaxel with good radiographic response. She then underwent total hysterectomy, bilateral salpingo-oophorectomy and lysis of adhesions in March 2017, and was noted to have a complete response intraoperatively, with no residual disease visible at the end of surgery. Her family history was significant for ovarian cancer, and she had a background history of viral cardiomyopathy with mildly reduced left ventricular ejection fraction. After 12 months, she presented with a headaches and unsteady gait. Later, she underwent stereotactic radiosurgery, targeting both intracranial lesions, followed by four cycles of carboplatin and gemcitabine. However, for the final two cycles, carboplatin was switched to cisplatin due to hypersensitivity. In November 2018, the woman was initiated on maintenance therapy with olaparib. Later, in October 2019, both intracranial lesions showed progression on surveillance brain MRI despite stable extracranial disease. Her brain metastases were targeted again with stereotactic radiosurgery, with a 3 week break in olaparib. In January 2020, she developed symptoms consistent with increased intracranial pressure, requiring a several weeks course of dexamethasone. However, she developed dexamethasone-induced diabetes mellitus. She also experienced a transient, acute rise in liver transaminases of unclear aetiology requiring a 2 week break in olaparib. In June 2020, repeat imaging was obtained for surveillance, demonstrating no recurrent disease extracranially.