PGY-2 Oncology Pharmacy Resident Memorial Cancer Institute Pembroke Pines, Florida, United States
Poster Abstract:
Background: Paclitaxel has a high incidence of hypersensitivity reactions (HSR) that can cause symptoms ranging from mild flushing to anaphylaxis. HSR are a boxed warning for paclitaxel and occur in 31 – 45% of patients. These reactions are typically immediate and happen within the first few minutes of the first or second infusion. It is recommended that patients receive prophylaxis with corticosteroids, histamine-1 and histamine-2 receptor antagonists prior to paclitaxel administration. This has been shown to decrease the incidence and severity of HSR. If HSR occurs, the infusion should be interrupted and supportive care should be administered until symptom resolution. Methods that lower HSR incidence including timing of pre-medications and infusion titration should be assessed prior to consideration of rechallenge methods. There is no consensus for rechallenging patients with a previous HSR, but common methods include administration at a lower infusion rate, adjustment of pre-medication regimen, and desensitization protocols.
Objective: This study will evaluate the incidence of paclitaxel HSR within the healthcare system to identify potential improvements or standardization of paclitaxel administration.
Methods: This retrospective chart review will be performed at an academic-community healthcare system using the electronic medical record from January 1, 2022 to January 1, 2023. Patients will be included if they are at least 18 years old and received at least one dose of paclitaxel for any cancer diagnosis. Up to 200 patients will be included within the study. Data collection will consist of age, legal sex, race, ethnicity, weight, cancer diagnosis, line of therapy, number of paclitaxel doses prior to HSR, pre-medications received day of reaction, completion of titration, incidence and timing of HSR, incidence of paclitaxel re-challenge, and incidence of regimen change. The primary outcome of this study is to determine the incidence of paclitaxel HSR at our healthcare system. The secondary outcome is time to HSR, and exploratory outcomes are rate of paclitaxel re-challenge and therapy switch. Data will be analyzed using descriptive statistics.
Results: Pending Discussion/
Conclusions: Pending
References (must also be included in final poster): 1. Lenz HJ. Management and preparedness for infusion and hypersensitivity reactions. Oncologist. 2007;12(5):601-609. doi:10.1634/theoncologist.12-5-601 2. Taxol (paclitaxel) [package insert]. Princeton, NJ: Bristol-Myers Squibb Company; 2011.
