Ha Young Jang, Boyoon Choi, In-Wha Kim, Hye Ryun Kang, Jung Mi Oh
{"title":"Risk factors of Hypersensitivity Reactions to Carboplatin: A Systematic Review and Meta-analysis.","authors":"Ha Young Jang, Boyoon Choi, In-Wha Kim, Hye Ryun Kang, Jung Mi Oh","doi":"10.1016/j.jaip.2024.12.021","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The development of hypersensitivity reactions (HSRs) to carboplatin can interrupt anticancer treatment and may shorten patient survival. Several studies have evaluated the risk factors for carboplatin HSRs, but the results have been inconclusive.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aim to establish a consensus on the risk factors of HSRs to carboplatin in cancer patients.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, relevant studies were searched across MEDLINE, EMBASE, and Korean Medical Database. Inclusion criteria focused on original articles of case-control or cohort studies that evaluated risk factors for carboplatin HSRs in cancer patients. Exclusion criteria targeted articles with incomplete or overlapping data. The latest search and quality assessment of the included studies, using the Newcastle-Ottawa scale, was performed on February 1, 2023.</p><p><strong>Results: </strong>Among 1,182 articles identified, 19 studies were included in the final systematic review and meta-analysis. The identified risk factors for carboplatin hypersensitivity included a history of allergy to medicines, food, or environmental factors (OR of 1.76, 95% CI 1.46 - 2.12), BRCA mutation (OR of 4.03, 95% CI 2.00 - 8.13), carboplatin free interval of 12 months or more (OR of 4.93, 95% CI 2.89 - 8.40), increased cumulative dose (SMD of 0.58, 95% CI 0.41 - 0.75), relapse (OR of 2.26, 95% CI 1.58 - 3.25), and younger age (SMD of -0.15, 95% CI: -0.26 - -0.03).</p><p><strong>Conclusion: </strong>This meta-analysis provides the first comprehensive quantitative evaluation of risk factors for carboplatin HSRs in cancer patients. These findings can guide the development of personalized risk assessment tools and preventive strategies, potentially improving patient safety and treatment outcomes in carboplatin-based chemotherapy.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":" ","pages":""},"PeriodicalIF":8.2000,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Allergy and Clinical Immunology-In Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jaip.2024.12.021","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The development of hypersensitivity reactions (HSRs) to carboplatin can interrupt anticancer treatment and may shorten patient survival. Several studies have evaluated the risk factors for carboplatin HSRs, but the results have been inconclusive.
Objective: This systematic review and meta-analysis aim to establish a consensus on the risk factors of HSRs to carboplatin in cancer patients.
Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, relevant studies were searched across MEDLINE, EMBASE, and Korean Medical Database. Inclusion criteria focused on original articles of case-control or cohort studies that evaluated risk factors for carboplatin HSRs in cancer patients. Exclusion criteria targeted articles with incomplete or overlapping data. The latest search and quality assessment of the included studies, using the Newcastle-Ottawa scale, was performed on February 1, 2023.
Results: Among 1,182 articles identified, 19 studies were included in the final systematic review and meta-analysis. The identified risk factors for carboplatin hypersensitivity included a history of allergy to medicines, food, or environmental factors (OR of 1.76, 95% CI 1.46 - 2.12), BRCA mutation (OR of 4.03, 95% CI 2.00 - 8.13), carboplatin free interval of 12 months or more (OR of 4.93, 95% CI 2.89 - 8.40), increased cumulative dose (SMD of 0.58, 95% CI 0.41 - 0.75), relapse (OR of 2.26, 95% CI 1.58 - 3.25), and younger age (SMD of -0.15, 95% CI: -0.26 - -0.03).
Conclusion: This meta-analysis provides the first comprehensive quantitative evaluation of risk factors for carboplatin HSRs in cancer patients. These findings can guide the development of personalized risk assessment tools and preventive strategies, potentially improving patient safety and treatment outcomes in carboplatin-based chemotherapy.
期刊介绍:
JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases.
This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders.
The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.