D3.106 - Real-life outcomes of rapid drug desensitization to taxanes

Taxanes are a frequent cause of immediate hypersensitivity reactions during chemotherapy, most commonly related to non–IgE-mediated mechanisms such as cytokine release. Rapid drug desensitization (RDD) allows continuation of first-line oncologic treatment in patients with taxane hypersensitivity. However, real-life data on clinical outcomes and transition to standard administration after desensitization remain limited.

We conducted a retrospective observational study including all patients evaluated for suspectedhypersensitivity to taxanes and referred for allergy assessment during 2025 in a tertiary Allergy Department. After standardized allergy evaluation and multidisciplinary discussion, rapid drug desensitization protocols were implemented when indicated according to clinical risk. Clinical outcomes and the ability to continue taxane treatment under standard administration protocols were recorded.

Fourteen patients with suspected hypersensitivity to taxanes were evaluated. Five patients did not initiatedesensitization due to changes in oncologic treatment strategy. Two patients initiated desensitization but did not complete the process: one due to disease progression and one due to remission after surgery. Seven patients completed the desensitization process and tolerated final administration under standard infusion conditions, allowing continuation of taxane treatment in the oncology day hospital without further hypersensitivity reactions. No severe breakthrough reactions were observed.

In real-life clinical practice, rapid drug desensitization to taxanes is a safe strategy. In selected patients with non–IgE-mediated reactions, desensitization may allow transition to standard drug administration, avoiding the need for repeated desensitization protocols and facilitating continuation of oncologic treatment.