Hypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions through an immunologic mechanism have been established for platinum and taxane agents, which are used to treat a wide variety of cancers including gynecologic cancers. Platin HSRs typically occur after multiple cycles of chemotherapy, reflecting the development of drug IgE sensitization, while taxane HSRs often occur on first or second exposure. Despite observed differences between platin and taxane HSRs, drug desensitization has been an effective method to reintroduce both chemotherapeutic agents safely. Skin testing is the primary diagnostic tool used to risk-stratify patients after initial HSRs, with more widespread use for platinum agents than taxanes. Different practices exist around the use of skin testing, drug challenge, and choice of desensitization protocol. Here, we review the epidemiology, mechanism, and clinical presentation of HSRs to platinum and taxane agents, as well as key controversies in their evaluation and management.

对化疗药物的超敏反应 (HSR) 可能对采用首选或一线疗法治疗患者构成严重挑战。铂类和紫杉烷类药物可通过免疫机制产生过敏反应，这些药物用于治疗多种癌症，包括妇科癌症。铂 HSR 通常发生在多个化疗周期后，反映了药物 IgE 致敏的发展，而紫杉烷 HSR 通常发生在第一次或第二次暴露时。尽管观察到铂和紫杉烷 HSR 之间存在差异，但药物脱敏一直是安全重新引入这两种化学治疗剂的有效方法。皮肤测试是初始 HSR 后用于对患者进行风险分层的主要诊断工具，铂类药物的使用比紫杉类药物更广泛。围绕使用皮肤测试、药物挑战和脱敏方案的选择存在不同的做法。在这里，我们回顾了 HSR 对铂类和紫杉类药物的流行病学、机制和临床表现，以及评估和管理中的关键争议。