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Does Rapid Drug Desensitization to Chemotherapy Affect Survival Outcomes?

Berges-Gimeno MP1*, Carpio-Escalona LV1*, Longo-Muñoz F2, Bernal-Rubio L1, Lopez-Gonzalez P1, Gehlhaar P1, Pachon V2, Ferreiro-Monteagudo R2, Madrigal-Burgaleta R1**, Alvarez-Cuesta E1**

1Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain
2Medical Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain
*These authors share first-author credit
**These authors share last-author credit

J Investig Allergol Clin Immunol 2020; Vol 30(4) : 254-263
doi: 10.18176/jiaci.0425

Background: Hypersensitivity reactions to oxaliplatin may affect prognosis by jeopardizing the timely completion of scheduled treatment sessions or by forcing reactive patients into unexpected changes in therapy. Rapid drug desensitization (RDD) enables these patients to receive their first-choice treatments safely. However, the possible effects of RDD on the efficacy of oxaliplatin have never been studied.
Objective: The objective of this study was to evaluate the effect of RDD on survival rates in oxaliplatin-hypersensitive patients.
Methods: We performed a 7-year retrospective study to compare survival between oxaliplatin-hypersensitive cases (patients receiving oxaliplatin by RDD) and nonallergic controls (patients receiving standard oxaliplatin infusions). The primary endpoint of this study was overall survival (OS) in cases and controls (Kaplan-Meier method with log-rank test comparisons).
Results: OS was 23.7 months (95%CI, 15.3-30.9) for the 67 cases who underwent 337 RDDs, while for controls (n=143), OS was 34.5 months (95%CI, 21.7-55.5). There were no significant differences between the groups (HR, 1.42; 95%CI, 0.93-2.17; =.104).
Conclusions: Survival outcomes of oxaliplatin-hypersensitive patients who received oxaliplatin via RDD did not differ significantly from those of control patients who received oxaliplatin via standard administration. Receiving oxaliplatin by means of RDD might be an effective therapeutic alternative for oxaliplatin-hypersensitive patients.

Key words: Drug allergy, Desensitization, Survival study, Hypersensitivity, Oxaliplatin, Skin test, Drug provocation test, Chemotherapy