Introduction: Osimertinib is an approved therapy for patients with a Thr790met (T790M) mutation diagnosed with non-small cell lung cancer (NSCLC) that progresses during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. However, in 7–13% of patients, drug-related side effects lead to discontinuation of osimertinib treatment. In such cases, osimertinib desensitization is a treatment option that can be considered. Case report: A 59-year-old female patient, who was followed up with the diagnosis of stage 4 NSCLC, was consulted to the allergy clinic because of urticaria. The patient developed urticaria plaques 20 h after the third dose of osimertinib tablet. Management & outcome: With the diagnosis of osimertinib-induced urticaria, desensitization was planned for the patient. Treatment was started with a dose of 0.1 mg/day osimertinib. The procedure was completed in approximately 50 days, and a dose of 80 mg/day was reached with antihistamine suppression. Discussion: Here, a successful osimertinib desensitization in a patient with a history of osimertinib-related type 1 allergic reaction is reported. Osimertinib desensitization is a treatment option that should be considered in cases where treatment has to be ceased due to drug-related side effects.

Background and Objectives: Drug provocation tests (DPTs) diagnose drug hypersensitivity reactions (DHRs) and identify safe alternatives. DHRs contribute to patient anxiety. The aim of this study was to evaluate anxiety and hopelessness levels before and after DPT and to examine patients’ avoidance characteristics of the tested drugs. Materials and Methods: Patients undergoing DPT were included. The State–Trait Anxiety Inventory (STAI) assessed anxiety, and the Beck Hopelessness Scale measured hopelessness. Demographic and clinical data, pre- and post-DPT scores, the status of using the medication provided after DPT, and the reason for not using it were analyzed. Results: Seventy-nine patients (60 female, 75.9%) participated. Patients’ Beck Hopelessness Scale, STAI–State, and STAI–Trait scores decreased significantly after the DPT compared to the initial scores. Among the patients who developed a reaction during the drug provocation test, the rate of those whose scale scores increased was significantly higher than the rate of those who did not develop a reaction. A total of 42 patients (53.2%) did not use the alternative safe drug. Of these, six (14.3%) reported that their reluctance stemmed from a fear of experiencing a reaction similar to their initial adverse event. Patients with concomitant allergic diseases were less likely to use alternative safe drugs. Conclusions: DPT reduces long-term anxiety and hopelessness. However, one in seven patients avoids the prescribed safe drug due to fear of recurrence. Effective communication, especially with patients who have allergic conditions or experience a reaction during DPT, and psychological support may improve adherence to the tested medication.

The aim of this study was to elucidate the incidence of local, large local and systemic reactions after subcutaneus immunotherapy (SCIT) injections in our clinic and to determine the characteristic features of these adverse reactions. A total of 6000 SCIT injections administered to 163 patients between January 2011 and December 2021 were retrospectively evaluated. The study population consisted of patients with allergic rhinoconjunctivitis who underwent SCIT due to pollen, house dust mite or cat allergy, or patients who underwent SCIT due to venom allergy. Demographic characteristics of the patients, diagnoses, allergen sensitivities, immunotherapy protocol applied, adverse reactions, and the characteristics of these reactions were recorded. Totally, 163 patients with a mean age of 36.8 ± 12.7 years were enrolled in this research. Sex distribution was as follows: 55.2% (n= 90) were females. During the study, 218 allergic reactions were detected in 83 patients. The incidence of adverse reactions per injection was 3.6%. The probability of developing an adverse reaction in a patient during the entire subcutaneous immunotherapy was 53.9%. Of the adverse reactions that developed, 94 (43.1%, n= 47) were observed locally while 56 (25.7%, n= 40) were large local reactions, and 68 (31.2%, n= 30) were systemic. Incidence of adverse reactions per injection were 1.5%, 0.9%, and 1.1% for local reaction, large local reaction, and systemic reaction, respectively. The results of this analysis elaborated that subcutaneous immunotherapy is a safe and tolerable treatment modality. However, before initiating treatment, the benefits and risks should be evaluated. The risk of systemic reactions is quite low, but fatal anaphylaxis can occur, so physicians need to be aware of the potential risks.

Aim: To present the characteristics of drug hypersensitivity reactions (DHRs) among taxane recipients with non-small cell lung carcinoma (NSCLC), and to describe the results of rapid drug desensitization (RDD). Methods: A retrospective cross-sectional study included 45 patients who were treated with taxane for NSCLC and were found to be hypersensitive to taxane. All patients were administered the standard 3-bag, 12-step RDD protocol following the development of DHR. RDD success was evaluated separately for each cycle, and successful RDD was defined as the completion of the cycle with application of 12 steps of the desensitization protocol and the absence of early and/or late reactions afterwards. Results: Among 45 patients hypersensitive to taxane 43 (95.6%) successfully received taxane cycles with desensitization. Failed RDD occurred in only 2 (4.4%) patients. The total number of desensitization cycles was 183, of which 181 (98.9%) were successful. The mean age of patients with successful desensitization was 59.42 ± 10.48 years and 37 (86.0%) of them were male. Conclusion: RDD is a reliable procedure that enables effective administration and completion of first-line taxane treatments in taxane-sensitive patients.