Pharmacy Service, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain
Allergy Service, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain.
Eur J Hosp Pharm. 2024 Oct 25;31(6):592-594. doi: 10.1136/ejhpharm-2023-003809.
We present the case of a patient with failed desensitisation to paclitaxel that was ultimately successful with omalizumab treatment. Our patient, a female aged between 20-25 and diagnosed with a triple negative breast cancer, received first-line treatment with carboplatin and paclitaxel. During the second cycle of paclitaxel, she experienced heat, dyspnoea, facial angioedema and vomiting. Skin tests for allergic reactions returned negative results, and drug provocation tests showed a positive result (anaphylaxis). Rapid drug desensitisation (RDD) was carried out with two bags of dilutions but at the beginning of the infusion, the patient experienced symptoms again, so the infusion was stopped. Therefore, the use of omalizumab, already reported as a successful adjuvant in desensitisation to other drugs, was considered. The anti-immunoglobulin E (IgE) monoclonal antibody was administered off-label before the first programmed desensitisation with success: total dose of paclitaxel was infused without any reaction. The patient was able to receive the complete chemotherapy treatment.
我们报告了一例紫杉醇脱敏治疗失败的患者，最终成功接受了奥马珠单抗治疗。我们的患者为一名 20-25 岁的女性，被诊断为三阴性乳腺癌，接受了卡铂和紫杉醇的一线治疗。在紫杉醇的第二个周期中，她出现了发热、呼吸困难、面部血管性水肿和呕吐。过敏反应的皮肤试验结果为阴性，药物激发试验显示阳性（过敏反应）。进行了快速脱敏（RDD），但在输液开始时，患者再次出现症状，因此停止了输液。因此，考虑使用奥马珠单抗，该药已被报道可成功辅助其他药物脱敏。在第一次有计划的脱敏治疗前，使用了抗免疫球蛋白 E（IgE）单克隆抗体，结果成功：未出现任何反应输注了全部剂量的紫杉醇。患者得以完成整个化疗治疗。
