893P - Predictors of hypersensitivity reactions (HSRs) in patients receiving carboplatin-based chemotherapy for ovarian cancer

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cytotoxic agents
Ovarian Cancer
Complications/Toxicities of treatment
Therapy
Biological therapy
Presenter Katarzyna Jerzak
Citation Annals of Oncology (2014) 25 (suppl_4): iv305-iv326. 10.1093/annonc/mdu338
Authors K.J. Jerzak1, S.D. Manshadi2, P. Ng2, M. Maganti1, J.M. McCuaig2, A.M. Oza1, H. Mackay2
  • 1Medical Oncology, Princess Margret Hospital, M5T2M9 - Toronto/CA
  • 2Medical Oncology, Princess Margret Hospital, Toronto/CA

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Abstract

Aim

Carboplatin offers high response rates and improved overall survival for women with ovarian cancer, but treatment may be limited by carboplatin-induced HSRs. We identified patients at high risk of carboplatin-induced HSRs that could be targeted for future prevention therapies.

Methods

A retrospective chart review of 452 patients with ovarian cancer receiving a sixth or subsequent cycle of carboplatin-containing chemotherapy from 2006 to 2012 at Princess Margaret Cancer Centre (PMCC) in Toronto, ON was performed. Age, cumulative number of treatment cycles, cumulative carboplatin dose, co-administered chemotherapy, BRCA status, use of prophylactic diphenhydramine and other allergies were noted. The pattern of carboplatin administration was recorded as either continuous, short (≤12 months) or long interval (>12months) since last receiving carboplatin-containing chemotherapy. Predictors of HSRs were assessed using the Chi-square, student's T-test and a multivariable logistic regression model.

Results

Carboplatin-induced HSRs occurred in 9% (n = 41/452) of patients, of which 4 were anaphylactic. Their median age was 57 (range 25 to 89). Sixteen percent received carboplatin alone; the remaining patients received co-administered Paclitaxel (74.5%), Caelyx (4.2%), Gemcitabine (2.4%) or another agent (2.7%). Thirty five percent received diphenhydramine prophylaxis. Univariable predictors of carboplatin-induced HSRs included the number of carboplatin cycles, other drug allergies and the platinum-free interval. Cumulative carboplatin dose, co-administered chemotherapy, diphenhydramine prophylaxis and BRCA status were not significant. In a multivariable model, factors predictive of HSRs included the administration of 8 to 10 cycles of carboplatin [OR 7.5 (95%CI 2.8-20.1), p < 0.01] as compared to 6 cycles and a long carboplatin-free interval [OR 4.4 (95%CI 1.1-17.6), p = 0.04] as compared to a short interval.

Conclusions

Ovarian cancer patients receiving 8 to 10 cycles of carboplatin-containing chemotherapy and those with a long interval (>12 months) since last receiving carboplatin are at an increased risk of carboplatin-induced HSRs. These patients may be targeted for future prevention therapies.

Disclosure

All authors have declared no conflicts of interest.