Cisplatin administration following acute hypersensitivity to other platinum compounds: A phase II study

Platinum compounds are antineoplastic agents widely used in numerous malignancies. A high percentage of patients exhibit carboplatin-associated hypersensitivity, especially after their seventh course of chemotherapy. The purpose of this study was to determine how useful skin tests are in ruling out cross-reaction to cisplatin, especially when treating physicians wish to continue platinum-based chemotherapy in patients responsive to these drugs. Prick tests were performed on three patients with medium and severe hypersensitivity to carboplatin. These tests were followed by intradermal tests with a series of carboplatin and cisplatin dilutions. Prick tests were negative for both carboplatin and cisplatin, whereas, in all patients, intradermal tests were positive with carboplatin and negative with cisplatin. Cisplatin was administered instead of carboplatin and was well tolerated by all patients without administering premedication. We reach the conclusion that intradermal skin tests can be used to detect cross-reaction between platinum compounds in order that platinum-based therapy is safely continued with a different platinum agent. This method requires neither desensitization nor premedication.

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