Background: Hypersensitivity reactions (HSRs) to taxane- and platinum-based chemotherapeutic agents are common and may interrupt essential cancer therapy. Rapid drug desensitization (RDD) enables patients to continue treatment safely; however, detailed analyses directly comparing desensitization outcomes between taxanes and platinums remain relatively uncommon. Objective: To describe the clinical characteristics of taxane- and platinum-induced HSRs and to compare desensitization outcomes, breakthrough reactions (BTRs), and graded-challenge success between these drug groups. Methods: This retrospective study included 27 patients who underwent 30 desensitization procedures, comprising 94 RDD cycles. Standardized 8-, 12-, or 16-step RDD protocols were applied based on the severity of the index reaction and the clinical risk assessment. Demographic and clinical data, characteristics of index HSRs, BTRs during RDD, and outcomes of graded challenges were recorded and analyzed. Results: Index HSRs most frequently occurred during the first or second infusion (66.6%) and were predominantly moderate in severity (53.3%). Cutaneous symptoms were present in 96.7% of reactions, and anaphylaxis occurred in 30%. Taxane HSRs developed significantly earlier than platinum reactions (69% vs. 24% during the first cycle, p=0.003). The overall RDD success rate was 97.9%. Seventeen BTRs (18.1%) occurred, most of which were mild (82.4%) and limited to cutaneous involvement (100%). BTRs were significantly more common with platinums than with taxanes (34.8% vs. 2.1%, p<0.001). Graded challenge was successful more often with taxanes than with platinums (53.8% vs. 17.6%, p=0.045). No severe or life-threatening BTRs were observed. Conclusion: RDD enabled the safe continuation of chemotherapy with both taxanes and platinums, with high success rates and infrequent, mostly mild BTRs. Platinum desensitizations carried a higher BTR risk, whereas selected taxane-allergic patients successfully transitioned to graded challenge. These findings support RDD as an effective strategy for managing chemotherapy-induced HSRs and highlight the need for individualized, risk-based protocol selection in clinical practice.
Sağun et al. (Sat,) studied this question.