• Albert S Braverman, Sujatha Rao, Mary Ellen Salvatti, Barbara Adamson, Margaret McManus, and Shirley Pierre.
• Downstate College of Medicine, State University of New York, New York, NY 11203-2098, USA. abraverman@downstate.edu
• Chemotherapy. 2005 May 1; 51 (2-3): 116-9.

BackgroundTaxanes cause hypersensitivity reactions, averted by premedication with H1 blockers and high glucocorticoid (GC) doses. Prolonged weekly taxane administration may lead to GC toxicity.PurposeTo determine whether patients not hypersensitive to initial paclitaxel (PTX) infusion after high-dose GC premedication will tolerate subsequent, prolonged PTX treatment without GC prophylaxis.Patients And MethodsIn 115/122 breast cancer patients not hypersensitive to initial PTX treatment, 20 mg dexamethasone (DXM) doses were tapered by 2.0 mg/week, reaching 0 in those receiving 9 or more courses. After 4 PTX courses, diphenhydramine was administered orally, rather than intravenously.ResultsPTX was administered 143 times after 2.0-5.0 mg of DXM and 357 times without DXM. A total of 46 patients received 1-40 PTX courses without DXM. None of these 115 patients experienced hypersensitivity reactions.ConclusionPatients unreactive to their first PTX infusions, after high-dose and tapering GC premedication, may not require GC prophylaxis for subsequent PTX therapy.Copyright 2005 S. Karger AG, Basel

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