Successful desensitization in paclitaxel-induced anaphylaxis: The role of skin testing and environmental sensitization

Hypersensitivity reactions (HSRs) to taxanes, such as paclitaxel, occur in 5% to 10% of patients and can involve immunoglobulin E (IgE) or non-IgE mechanisms. We report a 65-year-old male with lung cancer who developed anaphylactic shock during his second paclitaxel treatment. Positive intradermal tests raised the suspicion of an IgE-mediated reaction and, consequently, the possibility of prior sensitization through environmental exposure to <i>Taxus baccata</i> (European yew) pollen. The patient underwent a 17-step desensitization protocol with nab-paclitaxel, a formulation with a lower risk of HSRs, and successfully completed 6 additional treatment cycles without recurrence. This case highlights the role of skin testing, potential environmental factors in taxane allergies, and desensitization protocols as effective strategies to ensure safe and uninterrupted therapy.