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Medline ® Abstract for Reference 111

of 'Infusion reactions to systemic chemotherapy'

111
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Tapering and discontinuation of glucocorticoid prophylaxis during prolonged weekly to biweekly paclitaxel administration.
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Braverman AS, Rao S, Salvatti ME, Adamson B, McManus M, Pierre S
SO
Chemotherapy. 2005;51(2-3):116. Epub 2005 May 9.
 
BACKGROUND: Taxanes cause hypersensitivity reactions, averted by premedication with H1 blockers and high glucocorticoid (GC) doses. Prolonged weekly taxane administration may lead to GC toxicity.
PURPOSE: To determine whether patients not hypersensitive to initial paclitaxel (PTX) infusion after high-dose GC premedication will tolerate subsequent, prolonged PTX treatment without GC prophylaxis.
PATIENTS AND METHODS: In 115/122 breast cancer patients not hypersensitive to initial PTX treatment, 20 mg dexamethasone (DXM) doses were tapered by 2.0 mg/week, reaching 0 in those receiving 9 or more courses. After 4 PTX courses, diphenhydramine was administered orally, rather than intravenously.
RESULTS: PTX was administered 143 times after 2.0-5.0 mg of DXM and 357 times without DXM. A total of 46 patients received 1-40 PTX courses without DXM. None of these 115 patients experienced hypersensitivity reactions.
CONCLUSION: Patients unreactive to their first PTX infusions, after high-dose and tapering GC premedication, may not require GC prophylaxis for subsequent PTX therapy.
AD
Downstate College of Medicine, State University of New York, New York, NY 11203-2098, USA. abraverman@downstate.edu
PMID