First-line carboplatin/nab-paclitaxel in advanced ovarian cancer patients, after hypersensitivity reaction to solvent-based taxanes: a single-institution experience

• Published in: Clinical & translational oncology 2020, Vol.22 (1), p.158-162
• Main Authors: Parisi, A., Palluzzi, E., Cortellini, A., Sidoni, T., Cocciolone, V., Lanfiuti Baldi, P., Porzio, G., Ficorella, C., Cannita, K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Albumins - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Brief Research Article; Carboplatin - administration & dosage; Female; Follow-Up Studies; Humans; Hypersensitivity - etiology; Hypersensitivity - pathology; Medicine; Medicine & Public Health; Middle Aged; Oncology; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - pathology; Paclitaxel - administration & dosage; Prognosis; Retrospective Studies; Solvents - adverse effects; Solvents - chemistry; Taxoids - administration & dosage
• ISSN: 1699-048X; 1699-3055; 1699-3055
• DOI: 10.1007/s12094-019-02122-x

One of the major challenges related to solvent-based taxanes administration in clinical practice is the high rate of hypersensitivity reactions (HSRs). Nab-paclitaxel is a solvent-free, albumin-bound, paclitaxel, which minimize the risk of HSR occurrence. In this single-institution, retrospective analysis, we evaluated stage IIIc–IV epithelial ovarian cancer (EOC) patients, treated with first-line carboplatin/nab-paclitaxel (± bevacizumab), after the occurrence of an HSR with solvent-based paclitaxel (and/or docetaxel). Between April 2012 and December 2018, ten patients (20.8%) received carboplatin/nab-paclitaxel (± bevacizumab) after the occurrence of an HSR to solvent-based taxanes. Among the evaluable patients, ORR was 100%. At median follow-up of 28.5 months, median PFS was 16.7 months, and median OS was 65.4 months, respectively. Median received dose intensity (DI) was 86% and 80% of the projected DI for nab-paclitaxel and carboplatin, respectively. There were no treatment-related grade 4 adverse events. Most relevant treatment-related grade 3 adverse events were: asthenia (10%), hypertransaminasemia (10%), neutropenia (20%), thrombocytopenia (20%), and anemia (10%). No HSR recurrence was observed. The high rate of HSR occurrence could limit first-line treatment options in clinical practice. Carboplatin/nab-paclitaxel association could represent a valid treatment option in this setting.