Journal of Clinical Oncology, Vol 11, 885-890, Copyright © 1993 by American Society of Clinical Oncology
Successful re-treatment with taxol after major hypersensitivity reactions
DM Peereboom, RC Donehower, EA Eisenhauer, WP McGuire, N Onetto, JL Hubbard, M Piccart, L Gianni and EK Rowinsky
Johns Hopkins Oncology Center, Baltimore, MD 21287-8934.
PURPOSE: To describe the successful re-treatment of eight patients who had
major hypersensitivity reactions (HSRs) to taxol and to suggest a regimen
for re-treating patients who develop major HSRs. PATIENTS AND METHODS: The
treatment courses of eight patients who developed major HSRs and were
rechallenged with taxol were reviewed. Patients in this report represent
all patients who are known to have been rechallenged with taxol after major
HSRs. RESULTS: The most common approach used to rechallenge patients
consisted of premedication with multiple high doses of corticosteroids and
H1- and H2-histamine antagonists followed by the initiation of the taxol
infusion at a reduced rate. All patients who experienced major HSRs were
rechallenged successfully. After the rechallenge, these patients received
32 additional courses of taxol without HSRs. CONCLUSION: Re-treatment with
taxol after major HSRs is feasible using multiple high doses of
corticosteroids and antihistamine premedications and a reduced taxol
infusion rate under close supervision. This approach may represent a valid
alternative to the termination of taxol; however, a prospective evaluation
is required to determine the true efficacy of this approach.
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