A 15-min premedication for 1-h paclitaxel infusion: Optimizing patients’ care

Milani, Alessandra and De Pas, Tommaso and Noberasco, Cristina and McDonnel , Colette and Libutti, Livio and Limardi , Ivan and Zencovich, Claudia and Boselli , Sabrina and Bianchi, Monica and de Braud, Filippo (2007) A 15-min premedication for 1-h paclitaxel infusion: Optimizing patients’ care. Lung Cancer, 58 (2). pp. 300-301. ISSN 0169-5002

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Abstract

Paclitaxel is a plant product highly active in numerous cancers, but anaphylactic-like hypersensitivity reactions with it have been reported in about 28% of patients receiving the drug. Thirty to sixty minutes are needed to give a standard premedication with steroids and diphenhydramine, leading to patients and nurses' discomfort and stealing time from other infusional treatments. Eighty-nine patients with advanced NSCLC never pre-treated with taxanes, received paclitaxel followed by gemcitabine on days 1, 8, 15 q4wks. Premedication consisted of prednisone 25 mg/os on day 0 and hydrocortisone plus clorfenamina maleato given intravenous on day 1 by a 15 min infusion immediately before paclitaxel administration. Hypersensitivity reactions occurred in 3/341 (0.8%) cycles. In all three cases we observed severe dyspnoea and bronchospasm, that required treatment discontinuation but one was probably due to gemcitabine and another had a protracting time after premedication. A 15-min premedication infusion administered immediately before paclitaxel appeared to be highly effective in patients treated with 1h-infusion paclitaxel.

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