Comparison of infusion-related reactions to chemotherapy versus targeted therapy: A four-year experience at the Medical Day Hospital of the Fondazione IRCCS Istituto Nazionale Tumori Milano
Gabriella Mariani, Valentino Ippocrates Redaelli, Chiara Cavalli, Federica Manoni, Katia Fiorella Dotti, Laura Anna Maria FerrariBackground:
Infusion reactions (IRs) are a significant concern in oncology due to unpredictable onset and a lack of standardized management guidelines.
Objectives:
To compare the incidence, severity and management of IRs related to chemotherapy and targeted therapies in real-world practice, based on the experience of Medical Day Hospital at the Fondazione IRCCS Istituto Nazionale Tumori in Milan.
Methods:
A retrospective analysis of 73,057 non-investigational drug preparations (39,468 chemotherapies; 33,589 targeted therapies) was conducted between 2020 and 2023. The primary endpoint was the incidence of IRs per administration. Statistical comparison was performed using the Chi-square test.
Results:
A total of 646 IRs were observed (0.88%). The median age was 61 years (range 19-90), 75 % female and 25% male. The incidence was significantly higher for chemotherapy (1.17%) compared to targeted therapies (0.55%; p < 0.0001). The most problematic chemotherapies were paclitaxel (reaction risk 2.77%) and oxaliplatin (5.18%). For targeted therapies, rituximab (2.37%) and nivolumab (0.52%) showed the highest risk. Most reactions (97.4%) were mild (G1-G2) according to CTCAE 5.0.
Conclusions:
Chemotherapy remains associated with a significantly higher risk of IRs compared to targeted therapies. Although clinical presentations are similar, distinct pathophysiological mechanisms require tailored management and risk assessment.