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High-dose Dexamethasone Plus Antihistamine Prevents Colorectal Cancer Patients Treated With Modified FOLFOX6 From Hypersensitivity Reactions Induced by Oxaliplatin

High-dose Dexamethasone Plus Antihistamine Prevents Colorectal Cancer Patients Treated With Modified FOLFOX6 From Hypersensitivity Reactions Induced by Oxaliplatin

Yasuhiro Kidera, Taroh Satoh, Shinya Ueda, Wataru Okamoto, Isamu Okamoto, Soichi Fumita, Kimio Yonesaka, Hidetoshi Hayashi, Chihiro Makimura, Kunio Okamoto, Hidemi Kiyota, Junji Tsurutani, Masaki Miyazaki, etc.

Int J Clin Oncol. 2011 Jun;16(3):244-9.

PMID: 21243395

Abstract:

Background:
Oxaliplatin is a third-generation platinum compound and a key agent for the management of colorectal cancer. Patients treated with oxaliplatin are at risk for hypersensitivity reactions. We designed a modified premedication regimen to prevent oxaliplatin-related hypersensitivity reactions and assessed if this approach is effective.
Methods:
A retrospective cohort study of patients with advanced colorectal cancer who received modified FOLFOX6 (mFOLFOX6) was performed. Patients received routine premedication with dexamethasone 8 mg and granisetron 3 mg for the first five cycles of mFOLFOX6. From the sixth cycle onward, cohort 1 received the same premedication, and cohort 2 received modified premedication (diphenhydramine 50 mg orally, followed by dexamethasone 20 mg, granisetron 3 mg, and famotidine 20 mg). We compared the incidence of hypersensitivity reactions, duration of treatment, and reasons for treatment withdrawal between the two cohorts.
Results:
A total of 181 patients were studied (cohort 1, 81; cohort 2, 100). Hypersensitivity reactions developed in 16 patients (20%) in cohort 1 and 7 (7.0%) in cohort 2 (P = 0.0153). The median number of cycles increased from 9 in cohort 1 to 12 in cohort 2. Apart from progressive disease, neurotoxicity was the reason for discontinuing treatment in 20% of the patients in cohort 1, as compared with 53% in cohort 2.
Conclusion:
Increased doses of dexamethasone and antihistamine significantly reduced oxaliplatin-related hypersensitivity reactions. This effective approach should be considered for all patients who receive FOLFOX, allowing treatment to be completed as planned.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP127472428	Granisetron Related Compound A		127472-42-8	Price

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