Taxane-Related Hypersensitivity Reactions and Their Management: A Narrative Review
DOI:
https://doi.org/10.5530/ajphs.2026.16.95Keywords:
Cancer therapy, Chemotherapy, Desensitisation, Hypersensitivity reactions, Premedication, TaxanesAbstract
The major chemotherapeutic agent used in cancer, especially in breast, ovarian, lung and other solid tumours, is taxanes, i.e., Paclitaxel and Docetaxel. Even though they are widely used in our clinical settings, they are not free of side effects. One of the major side effects is hypersensitivity reactions, which may vary from minor rash and flushing to potentially fatal anaphylaxis. This is a narrative review that provides a comprehensive overview of taxane-induced hypersensitivity reactions, including their epidemiology, mechanisms, and clinical presentation, with greater emphasis on their management. Hypersensitivity reactions can occur during the initial cycles of therapy, within minutes of infusion, or eventually in subsequent cycles. The underlying mechanisms are complex, which involve not only immunological but also non- immunological pathways, including mast cell activation triggered by taxanes. In order to make taxane therapy more effective, proper preventive strategies are essential. Standard premedication regimens, including corticosteroids, antihistamines, ondansetron and H2 receptor antagonists, are routinely employed to reduce the risk of immediate hypersensitivity. Desensitisation protocols have emerged as an effective approach for patients who develop hypersensitivity reactions but require continued taxane therapy. The implementation of these strategies, along with the proper monitoring by a clinical pharmacist, results in the gradual reintroduction of the drug under controlled conditions. A multidisciplinary approach involving a pharmacist is essential for the effective management of taxane-induced hypersensitivity reactions and to ensure its safety and efficacy.
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