Br J Cancer: The added value of H2 antagonist ranitidine during paclitaxel treatment

Paclitaxel is one of the most commonly used anticancer drugs in the world.
It can effectively treat a variety of malignant tumors including breast cancer , lung cancer, ovarian cancer , head and neck cancer and esophageal cancer.
However, due to the hydrophobic nature of paclitaxel, it must be emulsified in Cremophor-EL (polyoxyethylene castor oil derivative), which also makes hypersensitivity reactions (HSR) often occur during paclitaxel infusion.

Ranitidine is a medicine used to treat gastroduodenal reflux and ulcer disease.
As an H2 blocker, it can be used to prevent HSR caused by paclitaxel infusion.
However, the added value of ranitidine in this preoperative medication regimen is still controversial.
Therefore, the study aimed to compare the incidence of HSR reactions between standard regimens including ranitidine and regimens without ranitidine during paclitaxel treatment.

This prospective, non-inferiority study compared standard preoperative medication regimens including dexamethasone, clemastine, and ranitidine with preoperative medication regimens without ranitidine.
The main outcome of the study was the incidence of HSR ≥ grade 3.

Distribution of patients

Both the pre-intervention group (with ranitidine) and the post-intervention group (without ranitidine) included 183 patients.
The results showed that the incidence of HSR ≥ grade 3 in the pre-intervention group was 4.
4% (N=8), while that in the post-intervention group was 1.
6% (N=3), a difference of -2.
7% between the two.
The upper limit of the 90% confidence interval (CI) does not exceed the predefined non-inferiority margin + 6%.

Univariate and multivariate analysis results

Therefore, the above research results show that the treatment plan without ranitidine is not inferior to the prevention plan with ranitidine.

Original source:

Cox, JM, van Doorn, L.