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This retrospective study assessed an HSR prevention protocol in metastatic colorectal cancer patients receiving oxaliplatin-containing regimens between 2005 and 2019. The protocol increased dexamethasone to 16.5 mg/body and prolonged oxaliplatin infusion time from 2 to 4 hours. Among 205 patients, 52.7% successfully reintroduced oxaliplatin with subsequent median progression-free survival of 6.4 months. Only 2.9% experienced grade 3 events, supporting potential avoidance of permanent discontinuation.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/high-dose-dexamethasone-and-prolonged-infusion-time-prevent-oxaliplatin-related-hypersensitivity-reactions-in-patients-with-metastatic-colorectal-cancer/354357/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/high-dose-dexamethasone-and-prolonged-infusion-time-prevent-oxaliplatin-related-hypersensitivity-reactions-in-patients-with-metastatic-colorectal-cancer/354357.png","ImageObject",300,407,{"name":92,"@type":93},"Kurz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What protocol was used to prevent oxaliplatin-related hypersensitivity reactions?","Question",{"text":112,"@type":113},"Dexamethasone was increased to 16.5 mg/body and oxaliplatin infusion time was extended from 2 to 4 hours.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How often was oxaliplatin successfully reintroduced after an HSR?",{"text":117,"@type":113},"Oxaliplatin was successfully reintroduced in 108 of 205 patients (52.7%) using the prevention protocol.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the major outcomes after reintroduction?",{"text":121,"@type":113},"The median oxaliplatin-free interval was 23 days, and the median progression-free survival after reintroduction was 6.4 months (95% CI: 4.6–8.2).",{"name":123,"@type":110,"acceptedAnswer":124},"What were common reasons for discontinuation?",{"text":125,"@type":113},"Discontinuation reasons included a second hypersensitivity reaction (47.3%), disease progression (36.1%), and chemotherapy-induced peripheral neuropathy (7.3%).","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},354357,1790183483,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149},2336478945635,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","International Journal of Clinical Oncology (2026) 31:1245–1257  \n[https://doi.org/10.1007/s10147-026-03037-8](https://doi.org/10.1007/s10147-026-03037-8)  \nHigh‑dose dexamethasone and prolonged infusion time prevent oxaliplatin‑related hypersensitivity reactions in patients with metastatic colorectal cancer  \nKoichiro Yoshino1 · Hiroki Osumi1 · Akira Ooki1 · Shohei Udagawa1 · MikakoTamba1 · Shota Fukuoka1 · Takeru Wakatsuki1 · Mariko Ogura1 · Keisho Chin1 · Kensei Yamaguchi1 · Eiji Shinozaki1  \nReceived: 13 August 2025 / Accepted: 3 April 2026 / Published online: 27 May 2026 © The Author(s) 2026  \nAbstract  \nBackground Oxaliplatin (OXA), a key cytotoxic agent used in the treatment of gastrointestinal cancers, is frequently discontinued due to hypersensitivity reactions (HSRs). We developed a protocol to mitigate HSRs and assessed its clinical efficacy. Methods We retrospectively analyzed HSRs in patients with metastatic colorectal cancer (mCRC) who were treated with OXA-containing regimens between 2005 and 2019. We evaluated the clinical utility of our HSR prevention protocol inpatients who experienced grade 1–3 HSRs following OXA-based chemotherapy. The protocol involved increasing dexamethasone to 16.5 mg/body and extending the OXA infusion time from 2 to 4 h.  \nResults Among 205 patients, 105 (51.2%) experienced grade 1, 95 (46.3%) grade 2, and 5 (2.4%) grade 3 HSRs. Most patients (87.8%) received either the FOLFOX4 or modified FOLFOX6 regimen. Patients underwent a median of 11 OXA cycles before their initial HSR. OXA was successfully reintroduced in 108 patients (52.7%) using the HSR prevention protocol. The median OXA-free interval was 23 days and the median progression-free survival after reintroduction was 6.4 months (95% confidence interval [CI]: 4.6–8.2). Reasons for discontinuation included a second HSR in 97 patients (47.3%), disease progression in 74 (36.1%), and chemotherapy-induced peripheral neuropathy (CIPN) in 15 (7.3%). Forty-six patients (22.4%) experienced an HSR during the initial prevention protocol. Only six patients (2.9%) experienced grade 3 HSRs and no grade 4 or 5 events were observed.  \nConclusion High-dose dexamethasone and prolonged infusion time may enable OXA reintroduction, providing an alternative to permanent discontinuation in mCRC patients with prior HSRs.  \nRegistry number 2024-GB-073 (retrospectively registered) .  \nKeywords Oxaliplatin · Hypersensitivity reaction · Prevention protocol · Metastatic colorectal cancer  \nIntroduction  \nColorectal cancer (CRC) is the fourth leading cause of cancer-related mortality worldwide, accounting for approximately 900,000 deaths annually. It also represents about 10% of all diagnosed cancers and cancer-related deaths globally.  \nKoichiro Yoshino and Hiroki Osumi the authors have contributed equally to this work.  \n* Eiji Shinozaki [eiji.shinozaki@jfcr.or.jp](eiji.shinozaki@jfcr.or.jp)  \n1 Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan  \nCRC is the second most common cancer in women and the third in men [1] . Although the prognosis for patients with metastatic colorectal cancer (mCRC) remains poor, it has improved in recent years due to advances in diagnostic techniques and treatment approaches, including surgery and chemotherapy.  \nOxaliplatin (OXA) is a third-generation platinum-based cytotoxic agent. Similar to other platinum-based agents, such as cisplatin (CDDP) and carboplatin (CBDCA), OXA exertsits antitumor activity by inhibiting DNA synthesis through cross-linking with DNA bases [2] . Structurally, OXA differs from other platinum compounds in that it contains a 1,2-diaminocyclohexane group as its carrier ligand and anoxalate group as its leaving group [2] . OXA demonstrates strong antitumor activity against CRC cell lines and is  \nconsidered a key drug in CRC treatment. Compared with CDDP, OXA is less nephrotoxic and less myeloto","cbCaiuMyA6m7ScQx","https://ap.wps.com/l/cbCaiuMyA6m7ScQx","pdf",809847,13,"English","# Abstract\n# Introduction\n## Oxaliplatin role and toxicity\n## Clinical features and risk of HSRs\n# Methods\n# Results\n# Conclusion","[{\"question\":\"What protocol was used to prevent oxaliplatin-related hypersensitivity reactions?\",\"answer\":\"Dexamethasone was increased to 16.5 mg/body and oxaliplatin infusion time was extended from 2 to 4 hours.\"},{\"question\":\"How often was oxaliplatin successfully reintroduced after an HSR?\",\"answer\":\"Oxaliplatin was successfully reintroduced in 108 of 205 patients (52.7%) using the prevention protocol.\"},{\"question\":\"What were the major outcomes after reintroduction?\",\"answer\":\"The median oxaliplatin-free interval was 23 days, and the median progression-free survival after reintroduction was 6.4 months (95% CI: 4.6–8.2).\"},{\"question\":\"What were common reasons for discontinuation?\",\"answer\":\"Discontinuation reasons included a second hypersensitivity reaction (47.3%), disease progression (36.1%), and chemotherapy-induced peripheral neuropathy (7.3%).\"}]","High-dose dexamethasone and prolonged infusion time prevent oxaliplatin-related hypersensitivity reactions in patients with metastatic colorectal cancer | PDF",1790110275,33]