ArticleInternational journal of clinical oncology2026
High-dose dexamethasone and prolonged infusion time prevent oxaliplatin-related hypersensitivity reactions in patients with metastatic colorectal cancer.
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOxaliplatin (OXA), a key cytotoxic agent used in the treatment of gastrointestinal cancers, is frequently discontinued due to hypersensitivity reactions (HSRs). We developed a protocol to mitigate HSRs and assessed its clinical efficacy.
methodsWe retrospectively analyzed HSRs in patients with metastatic colorectal cancer (mCRC) who were treated with OXA-containing regimens between 2005 and 2019. We evaluated the clinical utility of our HSR prevention protocol in patients who experienced grade 1-3 HSRs following OXA-based chemotherapy. The protocol involved increasing dexamethasone to 16.5 mg/body and extending the OXA infusion time from 2 to 4 h.
resultsAmong 205 patients, 105 (51.2%) experienced grade 1, 95 (46.3%) grade 2, and 5 (2.4%) grade 3 HSRs. Most patients (87.8%) received either the FOLFOX4 or modified FOLFOX6 regimen. Patients underwent a median of 11 OXA cycles before their initial HSR. OXA was successfully reintroduced in 108 patients (52.7%) using the HSR prevention protocol. The median OXA-free interval was 23 days and the median progression-free survival after reintroduction was 6.4 months (95% confidence interval [CI]: 4.6-8.2). Reasons for discontinuation included a second HSR in 97 patients (47.3%), disease progression in 74 (36.1%), and chemotherapy-induced peripheral neuropathy (CIPN) in 15 (7.3%). Forty-six patients (22.4%) experienced an HSR during the initial prevention protocol. Only six patients (2.9%) experienced grade 3 HSRs and no grade 4 or 5 events were observed.
conclusionHigh-dose dexamethasone and prolonged infusion time may enable OXA reintroduction, providing an alternative to permanent discontinuation in mCRC patients with prior HSRs. REGISTRY NUMBER: 2024-GB-073 (retrospectively registered).
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