# Drug desensitisation (rapid desensitisation to anticancer drugs)

Source: https://onco.cc/terms/drug-desensitisation/  
OnCo record `drug-desensitisation` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

If someone has had an allergic-type reaction to a cancer drug they still need, the drug can sometimes be given again very slowly, starting with a tiny dose and stepping up over several hours under close watch. This builds temporary tolerance, so treatment can continue.

## Summary

Desensitisation induces temporary tolerance to a drug allergen so that a first-choice drug can be continued after a hypersensitivity reaction. In the series by Castells and colleagues (2008), 98 patients who had reacted to carboplatin, cisplatin, oxaliplatin, paclitaxel, liposomal doxorubicin, doxorubicin or rituximab received 413 desensitisations with a standardised 12-step protocol, intravenously or intraperitoneally; 94% induced mild or no reactions, there were no life-threatening reactions or deaths, all patients received their full target dose, and most reactions occurred at the last step. The EAACI position paper (2022) notes that platinum compounds, taxanes, epipodophyllotoxins and asparaginase cause most chemotherapy hypersensitivity reactions, and covers skin tests, drug provocation tests and desensitisation in its recommendations. The tolerance is temporary, so the procedure is repeated for each course.

## Fields

- Kind: Term
- Last checked: 2026-11-11
- Also known as: Drug desensitization; Rapid drug desensitization; Desensitisation protocol; 12-step desensitization; Induction of drug tolerance
- Tags: supportive-care-gaps-2026-11

## Sources

- Castells et al., Hypersensitivity reactions to chemotherapy: outcomes and safety of rapid desensitization in 413 cases (J Allergy Clin Immunol 2008): https://europepmc.org/article/MED/18502492
- Hypersensitivity reactions to chemotherapy: an EAACI position paper (Allergy 2022): https://europepmc.org/article/MED/34587281

## Connected records

- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Oxaliplatin](https://onco.cc/drugs/oxaliplatin/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/), [Rituximab](https://onco.cc/drugs/rituximab/)
- terms: [Infusion reactions, hypersensitivity and extravasation](https://onco.cc/terms/extravasation-infusion-reaction/)

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