Pellegrino Benedetta, Boggiani Daniela, Tommasi Chiara, Palli Dante, Musolino Antonino
University Hospital of Parma.
Acta Biomed. 2017 Oct 23;88(3):329-333. doi: 10.23750/abm.v88i3.6138.
Taxanes, including paclitaxel and docetaxel, are one of the most active cytotoxic agents in breast cancer treatment including Her-2 positive subtype characterized by aggressive clinical and pathological features since the early stage. However, their use is sometimes limited by the occurrence of hypersensivity reactions (HSRs) characterized by erythematous rashes, bronchospasm, respiratory distress, hypotension, and pulmonary edema. Cross-reactions between paclitaxel and docetaxel are described in literature with a rate ranging from 49% to 90%. Abraxane (nab-paclitaxel), an albumin-bound form of paclitaxel, has a different toxicity profile from solvent-based paclitaxel and a lower rate of HSRs. Interestingly, several authors have recently reported cases of patients who developed HSRs to taxanes, principally paclitaxel, and were then safety treated with Abraxane, suggesting the absence of cross-reactivity between these drugs. Based on these considerations, we report our clinical experience and perform a literature review on this topic with the aim to investigate the cross-reactivity between nab-paclitaxel and other taxanes, in particular with docetaxel.
紫杉烷类，包括紫杉醇和多西他赛，是乳腺癌治疗中最有效的细胞毒性药物之一，适用于包括Her-2阳性亚型在内的乳腺癌治疗，该亚型从早期起就具有侵袭性的临床和病理特征。然而，它们的使用有时会受到过敏反应（HSR）的限制，过敏反应的特征包括红斑皮疹、支气管痉挛、呼吸窘迫、低血压和肺水肿。文献中描述了紫杉醇和多西他赛之间的交叉反应，发生率在49%至90%之间。白蛋白结合型紫杉醇（Abraxane）与溶剂型紫杉醇具有不同的毒性特征，且过敏反应发生率较低。有趣的是，最近有几位作者报告了一些病例，患者对紫杉烷类药物，主要是紫杉醇发生了过敏反应，随后用Abraxane进行了安全治疗，这表明这些药物之间不存在交叉反应。基于这些考虑，我们报告我们的临床经验，并对该主题进行文献综述，旨在研究白蛋白结合型紫杉醇与其他紫杉烷类药物之间的交叉反应，特别是与多西他赛之间的交叉反应。
