Docetaxel infusion cancelled due to severe reaction

[SkidiJay]

Hi all,

My dad (stage IV PCa w/ bone mets, lymph node involvement), who is on triplet therapy (lupron, darlutamide + docetaxel) went for his second cycle of chemo today. He took the first dose very well with only blurry vision. However, today we were shocked as the infusion had to be stopped after 15 minutes. His blood pressure rose sharply (he hasn‘t got hypertension and checks regularly), he started heaving sweats, blurry vision and hot flushes. Has anyone experienced anything similar in the past? I would not think he is allergic since he took the first dose without any issues.

We are now worried that he might not be able to continue with triplet as we expected, although we put a lot of hope in the approach. Any experiences, thoughts, are welcome.

[MJCA]

I’m not a doctor. But it definitely sounds like some sort of reaction - more than likely allergic. I was on Erleada 5.5 years and at that point it started making me dizzy all the time.

[Tall_Allen]

As with most allergies, the first dose sensitizes and the second dose gets a reaction. Maybe try with Jevtana, benadryl and dexamethasone.

[SkidiJay in reply to Tall_Allen]

Thanks  Tall_Allen , will definitely bring this forward with the MO! Dexamethasone was used, but the other two compounds have not, so we shall look into it. We have put a lot of hope into the triplet, as my dad is generally fit, so we‘d hope to be able to hit the cancer hard…

[Junenight]

I had an allergic reaction to my second infusion of docataxel after having no problems with my first. They said it is common and they could control it with medicine, which they did for all of my subsequent infusions, all of which I completed without any problems.

[dhccpa in reply to Junenight]

What medicine was used?

[Junenight in reply to dhccpa]

Dexamethasone (Decadron) and Diphenhydramine (Benadryl)

[dhccpa in reply to Junenight]

Thank you

[SkidiJay in reply to Junenight]

Thanks much, Junenight ! Will note this down for our next appointment at the hospital.

[Pattycakepgh]

This happened with my husband at first infusion. For all subsequent infusions they gave him Benadryl prior to starting the infusion, and his dosage was decreased. He had no problems during any infusion sessions once they did that.

[kiteND]

I had two infusions and it happened to me both times. My oncologist said that I could not have any more. The good news is that those two infusions killed a lot of the tumors.

[OuttaTime]

I had a severe reaction to docetaxel triple therapy fortunately the nurse was right there during my first dose my heart was tripping out had hot flashes and I was not able to speak right away they called it an allergic reaction. They slowed the rate of infusion way down and I was able to continue receiving that first infusion and all 6 infusions. So that worked for me was a slower dose and increased the total time of infusion. Also there are other chemo drugs that should work for your dad. I have stage 4 with bone Mets I am 67 years old. I am currently on lupron and darolutamide after the chemo. Keep us posted on his treatments. They also gave me other pre-drugs to help with the infusion I can’t remember them right now I will check my chart and post them.

[j-o-h-n]

From A I

Docetaxel is a chemotherapy medication commonly used to treat various cancers, including breast, prostate, and lung cancers. While it is effective, its infusion process can sometimes present issues. Here are some of the potential concerns and ways to address them:

1. Allergic Reactions

Symptoms: Flushing, rash, difficulty breathing, or hypotension during or shortly after infusion.

Cause: Docetaxel contains polysorbate 80, which may cause hypersensitivity reactions.

Management:

Premedication with corticosteroids (e.g., dexamethasone) and antihistamines.

Close monitoring during infusion, particularly the first dose.

Slowing or stopping the infusion if a reaction occurs, and administering supportive therapy

(e.g., epinephrine, oxygen).

Good Luck, Good Health and Good Humor.

j-o-h-n

[Sunnysailor]

my husband had this. They gave him benedryl. Then the next round he was given it at a slower rate and I think additional saline. He was eventually pulled off chemo for side effects. He got to check everyone off the list that they give you. My best advice is to advocate and then advocate more.

We changed oncologists in the middle of his treatment because I was fearful that they were going to kill him. When we got to Mayo he was immediately sent for a heart work up. They told us flat out no more chemo for the time being. His PSA is low and Nubeqa is doing most of the work due to a mutation. We were also told that there are other chemotherapy options that insurance only covers when Taxotere fails or can’t be used. I believe it was cabazitaxel.

I hope things improve for your dad.

[SkidiJay]

Hi all, thanks a lot for sharing your thoughts, knowledge and experiences. We will have a more in-depth discussion at the hospital.

Thus far my dad is on prednisolone for the duration of chemotherapy, he also takes dexamethasone prior to receiving it (tablets + infusion), and he was given a saline infusion right before (500 mililiters, to be precise).

My dad‘s impression was that the infusion time during the second cycle was indeed shorter, so it was interesting to hear that doing the exact opposite was helpful for some. You have given me hope that the SEs could be manageable and if not, that there are other options still. Thank you kindly for this! ❤️

[SkidiJay]

Good news from the next chemo attempt two days ago! My dad was given dimetindene on top of dexamethasone and prednisolon, that worked like a charm. The drip was at the same speed. He‘s a bit tired today, otherwise no noticable side effects. Thanks all for the advice!