Photo Credit: Dorin Puha

The following is a summary of “Effectiveness of Carboplatin-Prescreening Intradermal Skin Tests to Reduce Unanticipated Immediate Hypersensitivity Reactions: A Comparative Study,” published in the April 2024 issue of Allergy & Immunology by Lee, et al.

The administration of carboplatin carries a risk of immediate hypersensitivity reactions (IHRs), particularly increasing with repeated doses and commonly mediated by IgE. For a study, researchers sought to assess the effectiveness of carboplatin-prescreening intradermal skin tests (IDTs).

In January 2021, routine carboplatin-prescreening IDTs were performed in patients with a history of receiving six or more carboplatin cycles. The primary goal was to investigate differences in the incidence of unexpected IHRs to carboplatin administration between patients who underwent prescreening IDTs (intervention group, 2021–2022) and those who did not (preintervention group, 2019–2020). Secondary objectives included evaluating the sensitivity and specificity of the prescreening IDT and the incidence of carboplatin IHRs based on the number of infusion cycles.

The intervention group comprised 67 patients who received 347 carboplatin cycles, while the preintervention group consisted of 96 patients who received 464 carboplatin cycles. The risk of unexpected carboplatin IHRs decreased by 83.2% in the intervention group compared to the preintervention group (preintervention group: 3.45%, n = 16 vs. intervention group: 0.58%, n = 2; P = .005). The prescreening IDT exhibited a sensitivity of 77.78% and a specificity of 99.41%. The risk of newly developed IHRs varied based on the number of carboplatin cycles, ranging from less than 1% (cycles 1-5) to 0.74% (cycles 19 and above).

Implementation of carboplatin-prescreening IDTs from the seventh cycle onwards significantly reduced the risk of unexpected IHRs.

Reference: jaci-inpractice.org/article/S2213-2198(23)01350-8/abstract