Gynecologic oncology reports · 2025
Impact of carboplatin desensitization therapy on progression-free survival in gynecologic cancers.
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Bastin Nikita, Petrie Halle, Robinson Marc, Javid Amir, Lane Robin, Boucher Taryn, Brown Alaina J, Prescott Lauren S, Phillips Elizabeth, Alvarez Ronald D, Crispens Marta, Stone Cosby A
Аннотация
OBJECTIVES: To compare survival between gynecologic cancer patients with carboplatin hypersensitivity thereafter managed with carboplatin desensitization, cisplatin replacement, and alternative non-platinum therapy.
METHODS: A retrospective review of patients who experienced a hypersensitivity reaction to carboplatin and were treated at the same comprehensive cancer center between 2010 and 2024 was completed. The primary analysis compared progression-free survival between carboplatin desensitization, cisplatin substitution, and alternative non-platinum therapy patients. Secondary analysis compared survival between platinum therapy and non-platinum alternative therapy patients. Descriptive analysis was further performed to delineate the clinical phenotypes of patients with carboplatin hypersensitivity.
RESULTS: There were 47 gynecologic cancer patients with carboplatin hypersensitivity, and 38 patients with known progression-free survival. Progression-free survival was significantly longer in desensitized patients (31.1 months) vs. cisplatin patients (22.0 months, p = 0.045). There were no significant differences in progression-free survival between desensitized (31.3 months) and alternative therapy patients (36.0 months), as well as platinum (31.1 months) and non-platinum-based alternative therapy patients (36.0 months). A majority of our cohort was observed to have recurrent disease at the time of hypersensitivity (70.2 %), a carboplatin-free interval of 12 months or more (57.4 %), history of adverse reactions to other drugs (76.6 %), advanced stage disease (78.8 %), and serous histology (70.2 %).
CONCLUSIONS: Desensitized patients demonstrated increased progression-free survival as compared to cisplatin patients. This progression-free survival advantage may be due to the increased toxicity profiles noted for cisplatin and comparatively better tolerability of carboplatin desensitization. Progression-free survival was similar between carboplatin-desensitized and alternative therapy patients, as well as platinum-based and alternative therapy patients.
METHODS: A retrospective review of patients who experienced a hypersensitivity reaction to carboplatin and were treated at the same comprehensive cancer center between 2010 and 2024 was completed. The primary analysis compared progression-free survival between carboplatin desensitization, cisplatin substitution, and alternative non-platinum therapy patients. Secondary analysis compared survival between platinum therapy and non-platinum alternative therapy patients. Descriptive analysis was further performed to delineate the clinical phenotypes of patients with carboplatin hypersensitivity.
RESULTS: There were 47 gynecologic cancer patients with carboplatin hypersensitivity, and 38 patients with known progression-free survival. Progression-free survival was significantly longer in desensitized patients (31.1 months) vs. cisplatin patients (22.0 months, p = 0.045). There were no significant differences in progression-free survival between desensitized (31.3 months) and alternative therapy patients (36.0 months), as well as platinum (31.1 months) and non-platinum-based alternative therapy patients (36.0 months). A majority of our cohort was observed to have recurrent disease at the time of hypersensitivity (70.2 %), a carboplatin-free interval of 12 months or more (57.4 %), history of adverse reactions to other drugs (76.6 %), advanced stage disease (78.8 %), and serous histology (70.2 %).
CONCLUSIONS: Desensitized patients demonstrated increased progression-free survival as compared to cisplatin patients. This progression-free survival advantage may be due to the increased toxicity profiles noted for cisplatin and comparatively better tolerability of carboplatin desensitization. Progression-free survival was similar between carboplatin-desensitized and alternative therapy patients, as well as platinum-based and alternative therapy patients.