FARMACIA | 2021
PLATINUM HYPERSENSITIVITY REACTIONS, A FOCUS ON DESENSITISATION
Abstract
Platinum-based chemotherapy is the standard of care in a wide array of cancers. All chemotherapy, including platinum derivates, can cause hypersensitivity reactions which greatly limit their use due to the risk of anaphylaxis, forcing oncologists to use alternative chemotherapy, sometimes with a lower efficacy. The exact pathogenesis of platinum hypersensitivity reactions remains unknown, a type I mechanism is most frequently involved; however, type II, III, IV, or mixed mechanisms have also been described. Patients with atopy, a long platinum-free interval, treatment in palliative setting and higher cumulative dose are at risk of hypersensitivity. For these patients, desensitization protocols are available to treat allergic reactions to various agents, including platinum chemotherapy. Desensitization promotes antigen tolerance and allows the safe and efficient administration of the agent responsible for the hypersensitivity reaction. This review aims at providing insight into the current knowledge of platinum hypersensitivity with focus on available desensitization protocols.