Update on desensitization to chemotherapeutics and biologicals

Abstract

Hypersensitivity reactions to chemotherapeutics and biologicals are increasing, which can affect the prognosis of the underlying disease. Purpose of review: The goal of this review is to provide recent advancements in the diagnosis and management of hypersensitivity reactions based on current data. Recent findings: Multiple studies have provided evidence of the safety and efficacy of rapid drug desensitizations. The knowledge of recently described phenotypes (type I, cytokine release syndrome, and mixed reactions) and current biomarkers (tryptase, interleukin-6, skin testing, basophil activation, and specific IgE) allows a correct risk stratification, critical to guide the desensitization planning. Personalized protocols and premedications have been successfully used to decrease the number and severity of breakthrough reactions. Summary: Rapid drug desensitization allows patients to be treated with best therapies, increasing the quality of life and life expectancy.