Prophylactic Protocol for Carboplatin Hypersensitivity in High-Risk Patients With Gynecologic Cancer

BACKGROUND: Patients with gynecologic cancer may receive multiple lines of carboplatin therapies. Risk of a hypersensitivity reaction (HSR) increases after more than six doses and when resuming treatment after a platinum-based treatment break. This can lead to the discontinuation of therapy or to a complicated and time-consuming desensitization protocol for future cycles. Premedications or extended infusion times have shown varied results in reducing HSRs. OBJECTIVES: An increased incidence and severity of carboplatin-related HSRs led to the implementation of a prophylactic protocol to reduce the incidence and severity of HSRs. METHODS: Across a six-month period, infusion nurses administered 144 carboplatin infusions using the prevention protocol, which included oral steroid preparation, premedication prior to infusion, and a titrated rate of administration. FINDINGS: There were no carboplatin-related HSRs among patients in the pilot program compared to 21 HSRs (8%) among patients who received standard treatment.