Arimoto Takahide, Oda Katsutoshi, Nakagawa Shunsuke, Kawana Kei, Tsukazaki Takehiro, Adachi Katsuyuki, Matsumoto Yoko, Yano Tetsu, Kozuma Shiro, Taketani Yuji
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
J Obstet Gynaecol Res. 2013 Jan;39(1):336-40. doi: 10.1111/j.1447-0756.2012.01917.x. Epub 2012 Jun 13.
Platinum is a milestone drug against gynecologic malignancies. The purpose of this retrospective study was to investigate the feasibility of replacing carboplatin with nedaplatin in patients who had developed a hypersensitivity reaction to carboplatin.
Fifteen patients with recurrent gynecologic cancer (12 ovarian, 1 fallopian tube, 1 endometrial and 1 cervical cancer) who had experienced a hypersensitivity reaction to carboplatin and a possible clinical indication for continuing treatment with platinum were treated with nedaplatin (80 mg/m(2) )-containing regimen.
The total number of nedaplatin cycles given was 137 (range 1-29). Four (27%) patients developed hypersensitivity reactions on the second, second, fourth, and ninth administration, respectively. The severities of all the hypersensitivity reactions were grade 3 or less. The other 11 patients (73%) had no nedaplatin-associated hypersensitivity reactions. The incidence of hypersensitivity reactions in the paclitaxel and nedaplatin group (three of four, 75%) was more frequent than the docetaxel and nedaplatin group (none of seven, P=0.024). The objective response rate in eleven patients with measurable disease was 36% (complete response at 9% and partial response at 27%), and the disease control rate was 73% (stable disease at 36%).
Nedaplatin-associated hypersensitivity reactions are not rare in patients who developed allergic reactions to carboplatin. Retreatment of carboplatin-allergic patients with nedaplatin cannot be recommended without careful consideration of the potential risks and benefits.
铂类药物是治疗妇科恶性肿瘤的里程碑式药物。本回顾性研究旨在探讨对卡铂发生过敏反应的患者用奈达铂替代卡铂的可行性。
15例复发性妇科癌症患者（12例卵巢癌、1例输卵管癌、1例子宫内膜癌和1例宫颈癌）对卡铂发生了过敏反应且有继续铂类治疗的可能临床指征，接受含奈达铂（80mg/m²）方案治疗。
共给予奈达铂周期数为137个（范围1 - 29个）。4例（27%）患者分别在第2次、第2次、第4次和第9次给药时发生过敏反应。所有过敏反应的严重程度均为3级或以下。其他11例患者（73%）未发生与奈达铂相关的过敏反应。紫杉醇与奈达铂组的过敏反应发生率（4例中的3例，75%）高于多西他赛与奈达铂组（7例中的0例，P = 0.024）。11例可测量疾病患者的客观缓解率为36%（完全缓解率为9%，部分缓解率为27%），疾病控制率为73%（疾病稳定率为36%）。
对卡铂发生过敏反应的患者中，与奈达铂相关的过敏反应并不罕见。在未仔细权衡潜在风险和益处的情况下，不建议对卡铂过敏患者再次使用奈达铂进行治疗。
