{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:17:35Z","timestamp":1789564655784,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: After several decades of using titrated paclitaxel infusions, our institution adopted non-titrated infusions in April 2023 to streamline infusion workflows. We aimed to evaluate whether this alteration in infusion was associated with a higher incidence of HSRs. Methods: This was a retrospective cohort study of patients receiving paclitaxel with titration versus non-titration from April 2022 through November 2023. Patients diagnosed with gynecologic cancers who presented for their first or second paclitaxel lifetime infusions were included. Results: A total of 150 patients were included in this study, each with one or two infusions, for a total of 282 infusion visits. There were 176 infusions performed with titrated paclitaxel (62.4%), and 106 infusions performed with non-titrated paclitaxel dose (37.6%). HSRs occurred in 20.8% of the non-titrated paclitaxel infusions and in 11.9% of titrated paclitaxel infusions (RR 1.73 (95% CI 1.006\u20133.006), p = 0.047). Additionally, when stratifying by first- or second-visit infusions, the HSR rate increased significantly for non-titrated infusions to 22.4% during the second visit, while there was a decrease to 8.4% for titrated infusions (RR 2.66 (95% CI 1.105\u20136.413), p = 0.029). Non-titrated infusion reactions were associated with higher grades of reaction. Conclusions: HSRs occurred more frequently with non-titrated infusions, particularly during the second administration, suggesting that eliminating titration may increase hypersensitivity risk. These findings support a prospective evaluation of titration rates to further refine paclitaxel administration.<\/jats:p>","DOI":"10.3390\/cancers18061018","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T08:47:42Z","timestamp":1774255662000},"page":"1018","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Paclitaxel Hypersensitivity: Is Titrated Dosing in Gynecologic Oncology Patients Necessary?"],"prefix":"10.3390","volume":"18","author":[{"given":"Ester","family":"Goldfeld","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5538-1224","authenticated-orcid":false,"given":"Leigh","family":"Cantrell","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1016\/S0959-8049(01)00171-X","article-title":"Cremophor EL: The drawbacks and advantages of vehicle selection for drug formulation","volume":"37","author":"Gelderblom","year":"2001","journal-title":"Eur. 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Res."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/6\/1018\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T09:00:57Z","timestamp":1774256457000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/6\/1018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,21]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["cancers18061018"],"URL":"https:\/\/doi.org\/10.3390\/cancers18061018","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,21]]}}}