Docetaxel as an Alternative to Paclitaxel after Acute Hypersensitivity Reactions

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  • Bridget J Bernstein
    Bridget J Bernstein PharmD, Assistant Professor, Department of Pharmacy Practice, College of Pharmacy, Nova Southeastern University, Ft. Lauderdale, FL; Oncology Pharmacy Specialist, Memorial Regional Hospital, Hollywood, FL

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<jats:sec><jats:title>OBJECTIVE:</jats:title><jats:p> To review the mechanism involved in paclitaxel-induced hypersensitivity reactions and to evaluate the potential use of docetaxel after acute hypersensitivity reactions (HSRs) to paclitaxel. </jats:p></jats:sec><jats:sec><jats:title>DATA SOURCES:</jats:title><jats:p> Literature identified through a MEDLINE search (1966–September 2000) and through secondary sources. </jats:p></jats:sec><jats:sec><jats:title>DATA SYNTHESIS:</jats:title><jats:p> HSRs to paclitaxel can be life-threatening. The exact etiology involved in paclitaxel-induced HSRs has not been fully elucidated; the reactions may be due to the Cremophor EL vehicle or to paclitaxel itself. Options for treatment following HSRs are limited. A rechallenge attempt can be made, but is not always successful. Docetaxel, a semisynthetic taxane, may have a role in therapy for patients unable to tolerate paclitaxel therapy. This review examines the etiology of paclitaxel-induced HSRs and the potential role of docetaxel following these acute reactions. </jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS:</jats:title><jats:p> Docetaxel may be a viable alternative for patients who experience HSRs to paclitaxel. </jats:p></jats:sec>

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