Successful administration of carboplatin in patients with clinically documented carboplatin hypersensitivity

Objective. The goal of this study was to evaluate the tolerance and effectiveness of carboplatin rechallenge using a prolonged desensitizing carboplatin infusion regimen in patients with clinically documented moderate-severe carboplatin hypersensitivity. Methods. Patients admitted for carboplatin infusion were identified by computerized pharmacy records and retrospectively analyzed. Results. Thirty-three patients with recurrent ovarian (N = 27), peritoneal (N = 4), tubal (N = 1), and cervical (N = 1) cancer treated with a prolonged desensitizing carboplatin infusion regimen were identified. The patients had received a median of 10 courses of carboplatin (range 3-33) before developing the moderate-severe hypersensitivity reaction. Two hundred and fifteen courses (median 5, range 1-52) were administered. Twenty-nine patients (88%) were successfully rechallenged while four had a recurrent moderate-severe carboplatin hypersensitivity precluding further administration. Despite initial tolerance of the infusion schedule moderate-severe carboplatin hypersensitivity recurred in 3 additional patients (9%) after two, three, and six subsequent courses. Objective responses to therapy were seen in 22 of 28 evaluable patients (79%). Conclusions. A prolonged desensitizing carboplatin infusion regimen is tolerated in the majority of patients with clinically documented moderate-severe carboplatin hypersensitivity. Objective response rates seem acceptable with this schedule. (C) 2003 Elsevier Science (USA). All rights reserved.