Abstract 750P
Background
Carboplatin (CBDCA)-Paclitaxel based chemotherapy (CT) is the standard first-line treatment for advanced ovarian cancer. More than 70-80% of patients (pts) develop a relapse on an average of 10-20 months later. Pts with potentially platinum (Pt)-responsive recurrent disease are usually treated with a Pt-based treatment. The repeated exposure to Pt agents can be associated with potentially life-threatening hypersensitivity reactions (HSR). Risk factors of HSR are prior Pt exposure, more than 6 cycles of Pt agents, BRCA 1/2 mutations, history of allergic reactions to Pt agents.
Methods
A retrospective study was performed in pts with ovarian cancer who underwent CBDCA or cisplatin (CDDP) with two different desensitization protocols (DP) between 2017 and 2021 at our Institute. CBDCA DP used a 4-step dilution process over 4 h; CDDP DP used a 16 steps protocol with different infusion rates. Demographics characteristic of pts, atopic status, CT histories, and DP safety and efficacy outcomes were analyzed.
Results
20 pts with ovarian cancer treated with Pt DP were identified. Pts characteristics are summarized in the table. DP treatment included CBDCA based CT in 85% (17/20 pts) and CDDP based CT in 15% (3/20 pts). Of the 20 desensitization performed, 60% (12/20 pts) induced no reactions. Among pts who developed reactions during DP, symptoms and signs were mild (cutaneous rash and pruritus), with only 1 severe respiratory reaction requiring administration of epinephrine with complete resolution of symptoms. The overall disease control rate was 93% (14/15 pts), with 2/15 pts achieving a complete response, 1/15 patient partial response, 11/15 pts stable disease, 5 pts are not evaluable (4 pts are still on treatment). Table: 750P
| Characteristics (n=20) | Mean or frequency | Range or % |
| Atopic status Yes No | 8 12 | 40 60 |
| FIGO I-IIa IIb-IV | 4 16 | 20 80 |
| Histotype High grade serous carcinoma Other | 13 7 | 65 35 |
| BRCA 1/2 Mutated Wild-type Unknown | 6 10 4 | 30 50 20 |
| Type of surgery Primary debulking surgery Interval debulking surgery | 14 6 | 70 30 |
| First-line CT CBDCA-Paclitaxel CBDCA-Paclitaxel-Bevacizumab | 14 6 | 70 30 |
| Previous line with PARP-inhibitor Yes No | 6 14 | 30 70 |
| Number of CT cycles before HSR | 11 | 6-20 |
| Pt retreatment interval - interval time between the last cycle of first-line chemotherapy and platinum retreatment (months) | 29.7 | 11-93 |
| Reason for using DP Positive in vivo skin test Previous HSR | 6 14 | 30 70 |
Conclusions
DP with Pt-based regimens are effective and safe. Majority of pts completed the planned DP cycles, and no life-threatening HSR have occurred. Disease control was achieved in most of them.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.