Role of BRCA Mutation in Hypersensitivity Reactions to Chemotherapy in Ovarian Cancer
Posted: Monday, August 19, 2019
A retrospective chart review was conducted by Ali McBride, PharmD, of the University of Arizona, College of Pharmacy, and colleagues to determine whether the presence of BRCA mutations in patients with ovarian, fallopian tube, or primary peritoneal cancer increased the probability of hypersensitivity reactions to chemotherapy (carboplatin or paclitaxel). According to the researchers, BRCA mutations were not associated with a higher incidence of such reactions to carboplatin but were with regard to paclitaxel. Their analysis was published in the Journal of the Advanced Practitioner in Oncology.
In total, 62 patients (n = 13 BRCA-mutated, n = 49 BRCA wild-type) were evaluated. Of them, 15 were treated with carboplatin monotherapy; 47, combination therapy; and 44, carboplatin with paclitaxel. Patients with BRCA mutations (30.8%) did not experience increased hypersensitivity reactions to carboplatin compared with wild-type BRCA patients (44.9%). However, there was a statistically significant difference in hypersensitivity reactions to paclitaxel in patients with BRCA mutations (7.7%) compared with thos without the BRCA mutation (53.1%).
All reactions to carboplatin were of grade 3 or lower, and all reactions in BRCA-mutated patients were of grade 1. The most common reaction to paclitaxel was flushing (grade 2). No grade 4 or grade 5 reactions were observed.
“As carboplatin continues to be a major front-line treatment for ovarian, fallopian tube, and primary peritoneal cancer, it is paramount to monitor and try to predict whether patients will have an increased likelihood of hypersensitivity reactions based on risk factors such as genetics”, concluded the authors. “Since it is difficult to say with certainty whether the sole reaction to paclitaxel in the BRCA-mutated group was due to the drug itself, it may be beneficial in further studies to investigate such a reaction with formulations less likely to mask true hypersensitivity to the agent in question.”
Disclosure: The study authors reported no conflicts of interest.