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Carboplatin Hypersensitivity Timing — SCE Medical Oncology MCQ

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ModerateGynaecological CancersCarboplatin Hypersensitivity TimingSCE Medical Oncology

A 60-year-old woman with ovarian cancer on carboplatin develops acute anaphylaxis during her 8th cycle (first re-exposure after 6 cycles first-line and relapse). This is characteristic of carboplatin hypersensitivity. What is the typical timing of carboplatin allergic reactions?

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Correct answer: B — Usually after ≥6-8 cycles (≥6 lifetime exposures) — carboplatin hypersensitivity requires prior sensitisation and typically occurs on re-exposure during second-line or later platinum cycles; rates increase with cumulative exposure (1-5% after 6 cycles, 15-25% after >12 cycles)

Carboplatin hypersensitivity follows a predictable pattern: sensitisation occurs after ≥6 lifetime exposures, with increasing incidence on subsequent re-exposure cycles. First-line (6 cycles): ~1-5% allergy rate. Second-line re-exposure: ~10-15%. Third-line: ~25-35%. Reactions range from mild (rash, pruritus) to severe (anaphylaxis, cardiovascular collapse). Skin testing can predict hypersensitivity. Desensitisation protocols (graded reintroduction) allow continued platinum therapy in ~80-90% of cases. This is particularly relevant in ovarian cancer where multiple platinum lines are needed.

Reference: ESMO 2024 Ovarian Cancer; Markman et al JCO 2003; Lee et al Gynecol Oncol 2005