A Case of Possible Infusion-Related Reactions Caused by Palonosetron

Introduction: An infusion-related reaction (IRR) is an adverse event that typically occurs when cytotoxic drugs or monoclonal antibodies are administered. Palonosetron, a 5-hydroxytryptamine 3 receptor antagonist, is commonly used to prevent chemotherapy-induced nausea and vomiting....

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Main Authors: Toru Kadono, Hiroyuki Kodama, Hiroki Yukami, Toshifumi Yamaguchi, Hiroki Nishikawa
Format: Article
Language:English
Published: Karger Publishers 2025-02-01
Series:Case Reports in Oncology
Online Access:https://karger.com/article/doi/10.1159/000543992
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author Toru Kadono
Hiroyuki Kodama
Hiroki Yukami
Toshifumi Yamaguchi
Hiroki Nishikawa
author_facet Toru Kadono
Hiroyuki Kodama
Hiroki Yukami
Toshifumi Yamaguchi
Hiroki Nishikawa
author_sort Toru Kadono
collection DOAJ
description Introduction: An infusion-related reaction (IRR) is an adverse event that typically occurs when cytotoxic drugs or monoclonal antibodies are administered. Palonosetron, a 5-hydroxytryptamine 3 receptor antagonist, is commonly used to prevent chemotherapy-induced nausea and vomiting. IRRs due to palonosetron are very rare, with only two reports of anaphylactic shock due to palonosetron to date. We report a case with an IRR other than anaphylaxis. Presentation: A 75-year-old man with metastatic pancreatic cancer was receiving palliative chemotherapy. The patient repeatedly developed mild chills, shivering, fever and hypertension during or after infusion of cytotoxic agents such as liposomal irinotecan, gemcitabine, albumin-bound paclitaxel or oxaliplatin. Finally, as the IRR developed immediately after palonosetron, we concluded that palonosetron, which had been used as premedication in all previous regimens in which IRRs had occurred, was the causative agent. Discussion: Hypertension was considered to be one of the symptoms of IRR, although not typical. The rarity of palonosetron-induced IRRs and the delayed onset of IRRs made it difficult to establish that palonosetron was the cause of the IRRs. This report presents a rare case of IRR caused by palonosetron and details the course of IRR with palonosetron, which may help in the early recognition and appropriate management of future IRR with palonosetron.
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spelling doaj-art-2bf3653fd3004535a3d7b616dca25dfa2025-08-20T02:31:55ZengKarger PublishersCase Reports in Oncology1662-65752025-02-0118135336010.1159/000543992A Case of Possible Infusion-Related Reactions Caused by PalonosetronToru KadonoHiroyuki KodamaHiroki YukamiToshifumi YamaguchiHiroki Nishikawa Introduction: An infusion-related reaction (IRR) is an adverse event that typically occurs when cytotoxic drugs or monoclonal antibodies are administered. Palonosetron, a 5-hydroxytryptamine 3 receptor antagonist, is commonly used to prevent chemotherapy-induced nausea and vomiting. IRRs due to palonosetron are very rare, with only two reports of anaphylactic shock due to palonosetron to date. We report a case with an IRR other than anaphylaxis. Presentation: A 75-year-old man with metastatic pancreatic cancer was receiving palliative chemotherapy. The patient repeatedly developed mild chills, shivering, fever and hypertension during or after infusion of cytotoxic agents such as liposomal irinotecan, gemcitabine, albumin-bound paclitaxel or oxaliplatin. Finally, as the IRR developed immediately after palonosetron, we concluded that palonosetron, which had been used as premedication in all previous regimens in which IRRs had occurred, was the causative agent. Discussion: Hypertension was considered to be one of the symptoms of IRR, although not typical. The rarity of palonosetron-induced IRRs and the delayed onset of IRRs made it difficult to establish that palonosetron was the cause of the IRRs. This report presents a rare case of IRR caused by palonosetron and details the course of IRR with palonosetron, which may help in the early recognition and appropriate management of future IRR with palonosetron. https://karger.com/article/doi/10.1159/000543992
spellingShingle Toru Kadono
Hiroyuki Kodama
Hiroki Yukami
Toshifumi Yamaguchi
Hiroki Nishikawa
A Case of Possible Infusion-Related Reactions Caused by Palonosetron
Case Reports in Oncology
title A Case of Possible Infusion-Related Reactions Caused by Palonosetron
title_full A Case of Possible Infusion-Related Reactions Caused by Palonosetron
title_fullStr A Case of Possible Infusion-Related Reactions Caused by Palonosetron
title_full_unstemmed A Case of Possible Infusion-Related Reactions Caused by Palonosetron
title_short A Case of Possible Infusion-Related Reactions Caused by Palonosetron
title_sort case of possible infusion related reactions caused by palonosetron
url https://karger.com/article/doi/10.1159/000543992
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