Abstract 519P
Background
Oxaliplatin-related hypersensitivity reactions occur in 8.9-24% of patients and represent a clinical challenge for those who benefit from treatment. The use of desensitisation (desnst) protocols which include oral premedication starting 24 hours prior to treatment and continuing for a total of three days, intravenous premedication (30 minutes prior to treatment), and the gradual administration of oxaliplatin over 6.5 hours in four separate escalating doses (desnst protocol) has been tried with limited understanding of its efficacy. Here we present the experience of a tertiary cancer centre with this protocol.
Methods
Clinicopathological characteristics and oncological outcomes of patients with GI malignancies who received oxaliplatin- based chemotherapy treated with the desnst protocol between October 2019 and January 2024 at the Christie NHS Foundation Trust were reviewed.
Results
During the study period, 4220 patients were treated with 23,934 oxaliplatin-containing regimens. Sixty-seven patients with a median age of 60 years, 51% female, were studied. The majority had a diagnosis of CRC (n=35/67; 52%) and UGI (n=27/67, 40%) malignancy. More than two thirds of patients (n=53/67, 79%) were treated with palliative intent. The median number of cycles before the first hypersensitivity reaction was 2 (range 1-10) and the most common regimens associated with a reaction were CAPOX (n=33/67, 50%), FOLFOX (n=27/67, 39%), FLOT (n=1) and FOLFOXIRI (n=2). The median number of cycles in the desnst protocol was 3 (range 1-18). Most patients (n=57, 85%) continued their original oncology regimen during the desnst protocol without prematurely switching to an alternative chemotherapy regimen. Ten patients (15%) had another reaction that led to discontinuation of treatment. Treatment outcomes during desnst included 8 patients with no evidence of disease (7 in adjuvant setting), 27 patients with disease response to treatment and 32 patients with disease progression.
Conclusions
Oxaliplatin desensitisation is feasible with low discontinuation rates and leads to acceptable oncological outcomes. Patients should be offered oxaliplatin desensitisation to allow continuation of active systemic therapy.
Legal entity responsible for the study
The authors.
Funding
The Christie NHS Foundation Trust, Manchester, UK.
Disclosure
All authors have declared no conflicts of interest.