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Olaparib desensitization using the non-crushable tablet formulation
Olaparib desensitization using the non-crushable tablet formulation
Leonor P. Viegas 1, João Godinho 2, 3 
, Maria Nazaré-Rosado 3, 4 , José L. Passo- Coelho 2, 5 , Luís M. Borrego 1, 5
1 Department of Imunoallergology, LUZ SAÚDE, Hospital da Luz, Lisbon, Portugal; 2 Department of Oncology, LUZ SAÚDE, Hospital da Luz, Lisbon, Portugal; 3 Católica Medical School, Universidade Católica Portuguesa, Lisbon, Portugal; 4 Pharmacy and Drug Department, Nazaré, LUZ SAÚDE, Hospital da Luz, Lisbon, Portugal; 5 NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal
*Correspondence: Leonor P. Viegas. Email: leonor.paulos.viegas@hospitaldaluz.pt
Abstract
Previously reported desensitization protocols for olaparib relied on capsule or tablet suspensions that allowed very low starting doses, which are no longer commercially available in Europe. We describe a 40-year-old female with a pathogenic germline BRCA2 mutation, with triple-negative breast cancer with residual disease after neoadjuvant chemotherapy, who developed immediate cutaneous hypersensitivity after the first dose of adjuvant olaparib. A 2-day, hospital-based desensitization protocol was performed using the currently available non-crushable tablet formulation. A 2-day hospital build-up was performed, achieving a total dose of 400 mg, followed by a single-day build-up 7 days later to a cumulative dose of 600 mg, established as the maintenance regimen. This case supports the feasibility of olaparib desensitization using current tablet formulations and highlights the role of allergy-guided strategies in maintaining access to anticancer guided therapies.
Keywords: Olaparib. Drug desensitization. Drug allergy. Oncoallergology.
