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        Universal tolerance of nab­paclitaxel for gynecologic malignancies in patients with prior taxane hypersensitivity reactions

        Kathryn Maurer,Chad Michener,Haider Mahdi,Peter G. Rose 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4

        Objective: To report on the incidence of nab-paclitaxel hypersensitivity reactions (HSRs) inpatients with prior taxane HSR. Methods: From 2005 to 2015, all patients who received nab-paclitaxel for a gynecologicmalignancy were identified. Chart abstraction included pathology, prior therapy, indicationfor nab-paclitaxel, dosing, response, toxicities including any HSR, and reason fordiscontinuation of nab-paclitaxel therapy. Results: We identified 37 patients with gynecologic malignancies with a history of paclitaxelHSR who received nab-paclitaxel. Six patients (16.2%) had a prior HSR to both paclitaxel anddocetaxel while the other 31 patients had not received docetaxel. No patients experienced aHSR to nab-paclitaxel. Median number of cycles of nab-paclitaxel was 6 (range 2–20). Twelvepatients received weekly dosing at 60 to 100 mg/m2. The remainder of patients received 135mg/m2(n=13), 175 mg/m2(n=9), or 225 mg/m2(n=3). Thirty four patients (91.9%) receivedreceived nab-paclitaxel in combination with carboplatin (n=28, 75.7%), IP cisplatin (n=1,2.7%), carboplatin and bevacizumab (n=3, 8.1%), or carboplatin and gemcitabine (n=2,5.4%). Reasons for discontinuing nab-paclitaxel included completion of adjuvant therapy(n=16), progressive disease (n=18), toxicity (n=1), and death (n=1). There were no grade4 complications identified during nab-paclitaxel administration. Grade 3 complicationsincluded: neutropenia (n=9), thrombocytopenia (n=4), anemia (n=1), and neurotoxicity (n=1). Conclusion: Nab-paclitaxel is well-tolerated with no HSRs observed in this series of patientswith prior taxane HSR. Given the important role of taxane therapy in nearly all gynecologicmalignancies, administration of nab-paclitaxel should be considered prior to abandoningtaxane therapy

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