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, Masahiro Yoshinaga, Kimiko Fujiwara, Yuzuru Yamazoe, Kenzo Moriyama, Masanobu Tsubaki, Yasutaka Chiba, Shozo NishidaKazuhiko Nakagawa

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)

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 hypersensitive-ity 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 gra-nisetron 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 anti-histamine 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.

Original languageEnglish
Pages (from-to)244-249
Number of pages6
JournalInternational Journal of Clinical Oncology
Volume16
Issue number3
DOIs
Publication statusPublished - Jun 1 2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

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