# Comparison of rapid and same-day desensitization protocols in hypersensitivity reactions to platinum and taxanes: a retrospective cohort study

## TL;DR

This study compares two desensitization methods for patients with hypersensitivity to chemotherapy drugs and finds that same-day desensitization has a lower risk of breakthrough reactions.

## Contribution

The study provides a comparative analysis of rapid and same-day desensitization protocols using a Bayesian hierarchical model.

## Key findings

- The BTR rate was 24% in the RDD group and 15% in the SDD group.
- A Bayesian hierarchical model showed a 14.6-point reduction in BTR probability for the SDD group.
- Desensitization procedures were confirmed to be safe and effective.

## Abstract

Rapid drug desensitization (RDD) allows first-line treatment to continue after a hypersensitivity reaction to the antineoplastic agent. There are different desensitization procedures, and none of them are free from breakthrough reactions (BTR).

The objective of the study is to evaluate and compare the efficacy of different desensitization procedures, considering the effect of a series of confounding variables, and to describe the characteristics of BTRs in different procedures.

A retrospective, comparative review of medical records from patients who experienced hypersensitivity reactions to platinum- or taxane-based chemotherapy was conducted. Patients were categorized into two groups; rapid drug desensitization (RDD) and same-day desensitization (SDD), according to the intervention performed on the day of the initial reaction. Demographic data, drug, retreatment, cancer type, phenotype and severity of the initial reaction, allergy testing, number of desensitizations performed, outcome of desensitizations, and number, phenotype and severity of BTRs were recorded according to group.

In the RDD group, 406 desensitizations were analyzed in 76 subjects with a BTR rate of 24%. In the SDD group, 164 desensitizations were analyzed in 44 subjects with a BTR rate of 15%. A marginaleffects analysis using a Bayesian hierarchical model showed a 14.6-point reduction in the probability of BTR in the SDD group.

This study confirms that desensitization procedures are safe and effective and allows us to conclude, based on the data and the model, that the SDD group has a lower probability of BTR than the RDD group.