(161) Incidence of Paclitaxel Infusion-Related Reactions with Two Low-Dose Dexamethasone Premedication Strategies in Breast Cancer Patients

Poster Abstract: Background
Paclitaxel is widely used throughout the treatment continuum in breast cancer and is associated with a high rate of infusion-related reactions (IRRs) that requires premedication with diphenhydramine, a histamine 2 receptor antagonist, and dexamethasone. Prior to 2019, the dexamethasone premedication strategy at our institution included two oral 8 mg doses taken at home at 12 hours and 6 hours prior to each paclitaxel infusion and one intravenous (IV) 10 mg dose given 30 minutes prior to the infusion. In 2019, a protocol was implemented to omit the IV dose of dexamethasone in the infusion center if the patient had taken their oral doses as prescribed.

Objective(s)
The primary objective is to determine the incidence of IRRs related to paclitaxel infusion in breast cancer patients who received two oral doses of dexamethasone 12 hours and 6 hours prior to infusion compared to patients who received one IV dose of dexamethasone 30 minutes prior to infusion. The secondary objective is to identify variables associated with an increased risk of paclitaxel IRRs.

Methods
This is a single-center retrospective cohort study. Adult patients with a breast cancer diagnosis who had received at least one dose of paclitaxel in the outpatient setting from January 1, 2019 to October 10, 2023 were eligible for inclusion. Patients were excluded if they received any of their first three doses of paclitaxel prior to the study period or while admitted to the hospital, received oral dexamethasone premedication at the infusion center prior to paclitaxel, were taking corticosteroids other than dexamethasone as prescribed for paclitaxel premedication, or if the treatment plan had been modified such that it deviated from the premedication strategies being investigated. Patient allergies and infusion center nursing notes were used to identify and grade paclitaxel IRRs. Patients were identified through an electronic medical record query.
Statistical analysis of the primary outcome will be performed using the Chi-squared or Fisher’s exact test, as appropriate. Logistic regression analysis will be used for identification of variables associated with increased risk of IRRs. This study was designated by our Institutional Review Board as not human subjects research and exempted from review.

Results
Results pending.

Discussion/conclusion
Discussion/conclusion pending.

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