Tapering and discontinuation of glucocorticoid prophylaxis during prolonged weekly to biweekly paclitaxel administration.

Abstract:

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.

journal_name

Chemotherapy

journal_title

Chemotherapy

authors

Braverman AS,Rao S,Salvatti ME,Adamson B,McManus M,Pierre S

doi

10.1159/000085618

subject

Has Abstract

pub_date

2005-05-01 00:00:00

pages

116-9

issue

2-3

eissn

0009-3157

issn

1421-9794

pii

85618

journal_volume

51

pub_type

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