Toyooka, Japan
Toyooka, Japan

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Takase N.,Hyogo Cancer Center | Matsumoto K.,Hyogo Cancer Center | Onoe T.,Hyogo Cancer Center | Kitao A.,Public Toyooka Hospital | And 5 more authors.
International Journal of Clinical Oncology | Year: 2015

Background: Platinum agents are essential for treating gynecological malignancies, particularly ovarian cancer. However, multiple carboplatin doses may cause hypersensitivity reactions (HSRs). Carboplatin desensitization prevents life-threatening HSRs and promotes the successful completion of planned chemotherapy. Methods: Since January 2010, carboplatin desensitization was performed at our institution. Solutions with 1/1000, 1/100, and 1/10 dilutions of carboplatin and an undiluted solution were prepared in 250 mL of 5 % glucose. Each solution was administered as a 1-h intravenous infusion (4-step 4-h protocol). This retrospective analysis was approved by the institutional review board. Results: From January 2010 to December 2013, 20 patients with gynecological malignancies (median age 62 years, range 43–74 years) received desensitization treatment. The International Federation of Gynecology and Obstetrics stages at presentation were I, II, III, and IV in 1, 1, 15, 13 patients, respectively. During first-line and second-line treatments, 3 and 17 patients, respectively, experienced carboplatin-induced HSRs. The median carboplatin cycle number was 11 (range 2–16). In the first desensitization cycle, 17 (85 %) patients completed treatment without adverse events, 2 experienced Grade 1 HSRs but completed treatment, and 1 experienced Grade 3 HSR and discontinued treatment. The first desensitization cycle completion rate was 95 %. Of 83 desensitization cycles administered, 79 (95.2 %) were completed. No treatment-related deaths occurred. Conclusions: Most patients completed the planned chemotherapy. Our protocol could be conducted safely with shorter duration and simpler procedures than previous protocols. Carboplatin desensitization seems beneficial for patients with a history of carboplatin-induced HSRs; however, the risk of HSR recurrence still remains. Desensitization should therefore be performed only by well-trained staff. © 2014, Japan Society of Clinical Oncology.


Shimo T.,Kansai Medical University | Adachi Y.,Kansai Medical University | Adachi Y.,Public Toyooka Hospital | Umezawa K.,Keio University | And 5 more authors.
Clinical and Experimental Immunology | Year: 2011

Dehydroxymethylepoxyquinomicin (DHMEQ), a new nuclear factor (NF)-κB inhibitor, has several beneficial effects, including the suppression of tumour growth and anti-inflammatory effects. DHMEQ can also suppress the production of tumour necrosis factor (TNF)-α induced by lipopolysaccharide (LPS) in vitro. In the present study, we examine the effects of DHMEQ on TNF-α production in vivo and on the survival of mice injected with LPS. When DHMEQ was injected into mice 2h before LPS injection, the survival of the LPS-injected mice was prolonged. When DHMEQ was injected twice (2h before LPS injection and the day after LPS injection), all the mice were rescued. The injection of DHMEQ 1h after LPS injection and the day after LPS injection also resulted in the rescue of all mice. The serum levels of TNF-α in the mice that received both LPS and DHMEQ were suppressed compared to the mice that received only LPS. These results suggest that DHMEQ can be utilized for the prevention and treatment of endotoxin shock. © 2011 The Authors. Clinical and Experimental Immunology © 2011 British Society for Immunology.

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