Incidence Of Hypersensitivity Reactions To Carboplatin Or Paclitaxel In Patients With Ovarian, Fallopian Tube, Or Primary Peritoneal Cancer With Or Without Brca1 Or Brca2 Mutations.

e18758 Background: Platinum-based regimens have been shown to yield favorable outcomes for women with BRCA1 or BRCA2 mutations and metastatic ovarian, fallopian tube, or primary peritoneal cancers. As cumulative carboplatin exposure rises, incidence of hypersensitivity reactions (HSRs) to carboplatin rises as well, sometimes requiring cessation of therapy. Recent data have shown an association between cumulative carboplatin exposure and greater incidence of HSRs in individuals carrying a BRCA mutation. Many of these patients also receive combination chemotherapy with taxanes such as paclitaxel, which are known to cause significant hypersensitivity reactions. Methods: Retrospective chart review involving ovarian, fallopian tube, and primary peritoneal cancer patients at the University of Arizona Cancer Center who underwent treatment with a carboplatin-containing regimens between January 2012 and April 2016. Of these, 62 patients with BRCA test results constituted the evaluable sample. Fisher’s Exact test was used to analyze development of HSRs to carboplatin or paclitaxel. Results: Out of the 62 BRCA-tested patients, 15 were treated with carboplatin monotherapy and 47 with combination therapy containing carboplatin, including 44 with paclitaxel-containing regimens. HSRs occurred in 4/13 (30.8%) BRCA-mutated patients and 22/49 (44.9%) BRCA wild-type patients (p = 0.5291). In the paclitaxel group, HSRs were observed in 1/13 (7.7%) BRCA-mutated patients and 26/49 (53.1%) BRCA wild-type patients (p = 0.0039). Overall, there were 11 grade 1 reactions, 14 grade 2 reactions, and 16 grade 3 reactions to carboplatin, based on the CTCAE v4.0. All reactions to carboplatin in BRCA-mutated patients were grade 1. BRCA wild-type patients with grade 2 or 3 HSRs often presented with 2 or more symptoms. For those with paclitaxel HSRs, all events manifested as grade 2 reactions. Conclusions: Presence of a BRCA1 or BRCA2 mutation was not associated with a higher incidence of HSRs in patients receiving carboplatin. Further studies are needed to clarify the association between BRCA mutations and development of carboplatin or paclitaxel HSRs.