Successful Desensitization in Recurrent Paclitaxel Hypersensitivity: A Breast Cancer Case Report

Background Paclitaxel is a cornerstone in breast cancer treatment, but hypersensitivity reactions (HSRs) remain a frequent clinical challenge, usually related to the Cremophor EL solvent rather than IgE-mediated allergy. Although premedication decreases their incidence, breakthrough reactions may still compromise therapy. Case Report: We present the case of a 41-year-old woman with locally advanced breast carcinoma who developed acute erythematous and pruritic lesions during her first paclitaxel infusion. Despite intensified premedication and prolonged infusion, a second attempt triggered recurrent cutaneous reactions. Skin tests were negative, and the patient was referred to allergology. A standardized multi-step desensitization protocol was initiated under strict monitoring, which enabled successful reintroduction of paclitaxel. The patient completed all planned cycles without further hypersensitivity. Conclusion This case highlights that desensitization remains a safe and effective strategy to overcome recurrent paclitaxel hypersensitivity, allowing continuation of optimal taxane-based therapy in the neoadjuvant setting.