Risk Factors of Hypersensitivity Reactions to Carboplatin: A Systematic Review and Meta-Analysis

IF 8.2 1区医学 Q1 ALLERGY Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-03-01 DOI:10.1016/j.jaip.2024.12.021

Ha Young Jang PhD , Boyoon Choi PhD , In-Wha Kim PhD , Hye Ryun Kang MD, PhD , Jung Mi Oh PharmD

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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 aimed to establish a consensus on the risk factors of HSRs to carboplatin in patients with cancer.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 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 patients with cancer. 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 (odds ratio [OR] = 1.76; 95% CI, 1.46-2.12), BRCA mutation (OR = 4.03; 95% CI, 2.00-8.13), carboplatin free interval of 12 months or more (OR = 4.93; 95% CI, 2.89-8.40), increased cumulative dose (standardized mean difference, 0.58; 95% CI, 0.41-0.75), relapse (OR = 2.26; 95% CI, 1.58-3.25), and younger age (standardized mean difference, –0.15; 95% CI, –0.26 to –0.03).

Conclusions

To our knowledge, this meta-analysis provides the first comprehensive quantitative evaluation of risk factors for carboplatin HSRs in patients with cancer. 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.

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卡铂过敏反应的危险因素：系统回顾和荟萃分析。

背景：卡铂超敏反应（HSRs）的发展会中断抗癌治疗，并可能缩短患者的生存期。一些研究评估了卡铂hsr的危险因素，但结果尚无定论。目的：本系统综述和荟萃分析旨在就癌症患者对卡铂的hsr的危险因素达成共识。方法：根据系统评价和荟萃分析（PRISMA）指南的首选报告项目，在MEDLINE、EMBASE和韩国医学数据库中检索相关研究。纳入标准侧重于评估癌症患者卡铂HSRs危险因素的病例对照或队列研究的原始文章。排除标准针对数据不完整或重叠的文章。使用纽卡斯尔-渥太华量表对纳入的研究进行的最新搜索和质量评估于2023年2月1日进行。结果：在鉴定的1182篇文章中，有19项研究被纳入最终的系统评价和荟萃分析。识别卡铂过敏症的风险因素包括历史的过敏药物,食物,或环境因素(或1.76,95%可信区间1.46 - 2.12),BRCA突变(或4.03,95%可信区间2.00 - 8.13),卡铂免费间隔12个月以上的(或4.93,95%可信区间2.89 - 8.40),增加累积剂量(SMD 0.58, 95%置信区间0.41 - 0.75),复发(或2.26,95%可信区间1.58 - 3.25),和年轻的年龄(SMD的-0.15,95%置信区间CI: -0.26 - -0.03)。结论：该荟萃分析首次对癌症患者卡铂hsr的危险因素进行了全面定量评价。这些发现可以指导个性化风险评估工具和预防策略的开发，潜在地改善卡铂化疗的患者安全性和治疗结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

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.

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