Jang Ha Young, Choi Boyoon, Kim In-Wha, Kang Hye Ryun, Oh Jung Mi
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea; College of Pharmacy, Gachon University, Incheon, South Korea.
Program of Biopharmaceutical Science and Department of Pharmacy, College of Pharmacy and Institute of Pharmaceutical Sciences, CHA University, Pocheon, Gyeonggi, South Korea.
J Allergy Clin Immunol Pract. 2025 Mar;13(3):610-618.e10. doi: 10.1016/j.jaip.2024.12.021. Epub 2024 Dec 24.
The development of hypersensitivity reactions (HSRs) to carboplatin can interrupt anticancer treatment and may shorten patient survival. Several studies have evaluated the risk factors for carboplatin HSRs, but the results have been inconclusive.
This systematic review and meta-analysis aimed to establish a consensus on the risk factors of HSRs to carboplatin in patients with cancer.
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, relevant studies were searched across MEDLINE, Embase, and Korean Medical Database. Inclusion criteria focused on original articles of case-control or cohort studies that evaluated risk factors for carboplatin HSRs in patients with cancer. Exclusion criteria targeted articles with incomplete or overlapping data. The latest search and quality assessment of the included studies, using the Newcastle-Ottawa scale, was performed on February 1, 2023.
Among 1,182 articles identified, 19 studies were included in the final systematic review and meta-analysis. The identified risk factors for carboplatin hypersensitivity included a history of allergy to medicines, food, or environmental factors (odds ratio [OR] = 1.76; 95% CI, 1.46-2.12), BRCA mutation (OR = 4.03; 95% CI, 2.00-8.13), carboplatin free interval of 12 months or more (OR = 4.93; 95% CI, 2.89-8.40), increased cumulative dose (standardized mean difference, 0.58; 95% CI, 0.41-0.75), relapse (OR = 2.26; 95% CI, 1.58-3.25), and younger age (standardized mean difference, -0.15; 95% CI, -0.26 to -0.03).
To our knowledge, this meta-analysis provides the first comprehensive quantitative evaluation of risk factors for carboplatin HSRs in patients with cancer. These findings can guide the development of personalized risk assessment tools and preventive strategies, potentially improving patient safety and treatment outcomes in carboplatin-based chemotherapy.
对卡铂发生超敏反应（HSR）会中断抗癌治疗，并可能缩短患者生存期。多项研究评估了卡铂超敏反应的危险因素，但结果尚无定论。
本系统评价和荟萃分析旨在就癌症患者卡铂超敏反应的危险因素达成共识。
按照系统评价和荟萃分析的首选报告项目指南，在MEDLINE、Embase和韩国医学数据库中检索相关研究。纳入标准侧重于评估癌症患者卡铂超敏反应危险因素的病例对照研究或队列研究的原始文章。排除标准针对数据不完整或重叠的文章。2023年2月1日对纳入研究进行了最新检索，并使用纽卡斯尔-渥太华量表进行了质量评估。
在检索到的1182篇文章中，19项研究纳入了最终的系统评价和荟萃分析。确定的卡铂超敏反应危险因素包括有药物、食物或环境因素过敏史（比值比[OR]=1.76；95%可信区间[CI]，1.46 - 2.12）、BRCA突变（OR = 4.03；95%CI，2.00 - 8.13）、卡铂无用药间隔12个月或更长时间（OR = 4.93；95%CI，2.89 - 8.40）、累积剂量增加（标准化均数差，0.58；95%CI，0.41 - 0.75）、复发（OR = 2.26；95%CI，1.58 - 3.25）和年龄较小（标准化均数差，-0.15；95%CI，-0.26至-0.03）。
据我们所知，这项荟萃分析首次对癌症患者卡铂超敏反应的危险因素进行了全面的定量评估。这些发现可指导个性化风险评估工具和预防策略的开发，可能改善基于卡铂的化疗中的患者安全性和治疗效果。
