Second-generation platinum derivative carboplatin differs from cisplatin in the substitution of two chlorides by a 1,1-cyclobutane dicarboxylate group. Its efficacy in the treatment of many of the above malignancies is equal to that of cisplatin, and its toxicity profile is more favorable. Thus, carboplatin has often been used in place of cisplatin.

Oxaliplatin (ethanedioate- O, O′)platinum(II)] is a third-generation platinum compound widely used for the treatment of metastatic colorectal cancer and a variety of other malignancies, such as breast cancer, melanoma, non-Hodgkin lymphoma, and head and neck cancer. Common adverse events are myelotoxicity, nausea, vomiting diarrhea, paresthesia, and dysesthesias. Hypersensitivity to a chemotherapeutic agent is defined as an unforeseen reaction whose signs and symptoms cannot be explained by the known toxicity of the drug. Industrial complex platinum salts have been reported to cause hypersensitivity and asthma among refinery workers since 1945. Hypersensitivity reactions in patients receiving cisplatin were first described in the 1970s in patients who had been retreated with the drug. Since then, all platinum agents have been associated with such reactions. The aim of this paper is to provide recent data concerning hypersensitivity reactions to platinum-containing chemotherapy agents. We will present the characteristics and pathogenetic mechanisms of this hypersensitivity, as well as the basic management options available to date.Įxtensive use of platinum compounds in chemotherapy during the last decade has led to a significant increase in the incidence of hypersensitivity reactions ( Table 1). Hypersensitivity to carboplatin is rarely observed during the first course of treatment. In fact, the most striking difference of carboplatin hypersensitivity, when compared to nonplatinum agents, is the fact that most allergic reactions are reported after the patient has received a significant number of infusions although he has exhibited no hypersensitivity up until then.

Half of the reactions observed are moderate to severe. During the first five cycles, the overall risk is less than 1% it rises sharply to 6.5% with the sixth cycle and has been reported as high as 27% in patients receiving more than seven cycles of treatment.

Platinum notes review