A case successfully treated by desensitization for paclitaxel-associated hypersensitivity reactions

We report a case of a 56-year-old woman with hypersensitivity reactions (HSRs) symptoms against paclitaxel (PTX) which were suppressed by pre-injection of a low-dose of PTX before the full-dose injection. She received PTX chemotherapy (120 mg/body/week for three weeks on the 1st, 8th, and 15th day, followed by no drug for one week) in October 2004 for right breast cancer. However, continuation of the therapy was in jeopardy due to respiratory difficulties and facial flushing, considered to be HSRs symptoms, on day 15. However,we were able to continue the PTX chemotherapy by administering a low-dose pre-injection (2 mg/100 mL/30 min) before the full-dose injection. After that, HSRs symptoms were observed, but we were able to administer another low-dose pre-injection (1 mg/100 mL/30 min). Three courses of chemotherapy were successfully performed, followed by radical surgery in February 2005. A pathological complete response (pCR) of the maintumor was achieved. We suggest that pre-injection of a low-dose of PTX before the full-dose injection may be effective for prevention of the onset of HSRs symptoms.