Toki Maria I, Saif Muhammad Wasif, Syrigos Kostantinos N
National and Kapodistrian University of Athens, Sotiria General Hospital, Medical School, Third Department of Medicine, Oncology Unit , 152 Mesogeion Ave, 11527, Athens , Greece +30 210 770 0220 ; +30 210 778 1035 ;
Expert Opin Drug Saf. 2014 Nov;13(11):1545-54. doi: 10.1517/14740338.2014.963551. Epub 2014 Oct 11.
Oxaliplatin , has become an integral part of the medical treatment of colorectal cancer and other malignancies. Increased use of the drug during the last decade, has led to increased occurrence of oxaliplatin-induced hypersensitivity reactions (HSRs), posing a significant challenge for clinicians. This article aims to review the existing literature regarding the incidence, clinical presentation, pathophysiology, risk factors and current management of oxaliplatin-induced HSRs.
A systematic review of the English literature published in PubMed and Medline was undertaken. The clinical manifestations of HSRs were found to be variable and unpredictable. These reactions should be an important concern, as their potential life-threatening risks can force doctors to stop treatment and seek alternatives, which may be less effective, not as well tolerated and/or more expensive. There are a few strategies to prevent these reactions so that patients can still benefit from oxaliplatin. Such strategies include the use of premedication (steroid and antagonists of type I and II histamine receptors), prolonged infusion time and desensitization.
The presented management strategies as well as novel diagnostic tools including skin/intradermal tests and specific IgE have shown promising results. However, future research and validation are warranted in bigger clinical trials.
奥沙利铂已成为结直肠癌和其他恶性肿瘤药物治疗中不可或缺的一部分。在过去十年中，该药物使用的增加导致奥沙利铂诱导的超敏反应（HSRs）发生率上升，给临床医生带来了重大挑战。本文旨在综述有关奥沙利铂诱导的超敏反应的发生率、临床表现、病理生理学、危险因素及当前治疗方法的现有文献。
对发表于PubMed和Medline上的英文文献进行了系统综述。发现超敏反应的临床表现多样且不可预测。这些反应应引起重要关注，因为其潜在的危及生命的风险可能迫使医生停止治疗并寻求替代方案，而这些替代方案可能效果较差、耐受性不佳和/或成本更高。有一些预防这些反应的策略，以便患者仍能从奥沙利铂中获益。这些策略包括使用预处理药物（类固醇以及I型和II型组胺受体拮抗剂）、延长输注时间和脱敏。
所提出的治疗策略以及包括皮肤/皮内试验和特异性IgE在内的新型诊断工具已显示出有前景的结果。然而，未来需要在更大规模的临床试验中进行研究和验证。
