内容紹介
A Patient with Paclitaxel Hypersensitivity Treated with Nab-Paclitaxel
Summary
A 63-year-old man with multiple liver metastases from gastric cancer was treated with S-1 plus cisplatin; however, the number of multiple liver metastases increased. The patient received paclitaxel(PTX)treatment, but a hypersensitivity reaction occurred after administering the second dose; therefore, he received docetaxel treatment. A hypersensitivity reaction occurred after administering the first dose of docetaxel; therefore, he received irinotecan treatment. However, irinotecan administration was stopped because of severe diarrhea and weight reduction. Subsequently, at the patient's request, nab-PTX treatment was initiated by administering a premedication regimen of dexamethasone(8 mg)and chlorpheniramine(10 mg); no hypersensitivity reactions were reported thereafter. Nab-PTX is a contraindication; however, it might be possible to use nab-PTX for treating patients with PTX hypersensitivity.
要旨
症例は63歳,男性。胃癌,多発肝転移に対してS-1/cisplatin療法を施行したが,肝転移の増大を認め治療変更となった。paclitaxel(PTX)に変更するも2回目投与時に過敏症の発現があり投与を中止,docetaxelに変更するも初回投与時に過敏症の発現があり投与を中止し,その後irinotecan療法を施行したが下痢と体重減少で投与困難となった。次治療として本人の希望でnab-PTXを前投薬(dexamethasone 8 mg+chlorpheniramine 10 mg)を併用して投与したところ,過敏症の発現なく投与可能であった。nab-PTXは添付文章上ではPTX過敏症患者に投与禁忌だが,本症例のようにポリオキシエチレンヒマシ油含有PTX過敏症患者に対してnab-PTXによる治療継続が可能である場合がある。
目次
Summary
A 63-year-old man with multiple liver metastases from gastric cancer was treated with S-1 plus cisplatin; however, the number of multiple liver metastases increased. The patient received paclitaxel(PTX)treatment, but a hypersensitivity reaction occurred after administering the second dose; therefore, he received docetaxel treatment. A hypersensitivity reaction occurred after administering the first dose of docetaxel; therefore, he received irinotecan treatment. However, irinotecan administration was stopped because of severe diarrhea and weight reduction. Subsequently, at the patient's request, nab-PTX treatment was initiated by administering a premedication regimen of dexamethasone(8 mg)and chlorpheniramine(10 mg); no hypersensitivity reactions were reported thereafter. Nab-PTX is a contraindication; however, it might be possible to use nab-PTX for treating patients with PTX hypersensitivity.
要旨
症例は63歳,男性。胃癌,多発肝転移に対してS-1/cisplatin療法を施行したが,肝転移の増大を認め治療変更となった。paclitaxel(PTX)に変更するも2回目投与時に過敏症の発現があり投与を中止,docetaxelに変更するも初回投与時に過敏症の発現があり投与を中止し,その後irinotecan療法を施行したが下痢と体重減少で投与困難となった。次治療として本人の希望でnab-PTXを前投薬(dexamethasone 8 mg+chlorpheniramine 10 mg)を併用して投与したところ,過敏症の発現なく投与可能であった。nab-PTXは添付文章上ではPTX過敏症患者に投与禁忌だが,本症例のようにポリオキシエチレンヒマシ油含有PTX過敏症患者に対してnab-PTXによる治療継続が可能である場合がある。