Management of infusion-related reactions in cancer therapy: strategies and challenges

Abstract

Several anticancer therapies have the potential to cause infusion-related reactions (IRRs) in the form of adverse events that typically occur within minutes to hours after drug infusion. IRRs can range in severity from mild to severe anaphylaxis-like reactions. Careful monitoring at infusion initiation, prompt recognition, and appropriate clinical assessment of the IRR and its severity, followed by immediate management, are required to ensure patient safety and optimal outcomes. Lack of standardization in the prevention, management, and reporting of IRRs across cancer-treating institutions represents not only a quality and safety gap but also a disparity in cancer care. The present article, supported by recently published data, was developed to standardize these procedures across institutions and provide a useful tool for health care providers in clinical practice to recognize early signs and symptoms of an IRR and promptly and appropriately manage the event.

Keywords: cancer; infusion; infusion reaction; management; standardization; therapy.

Figure 1

Signs and symptoms of infusion reactions.

Figure 2

Workflow for the management of infusion reactions related to anticancer therapies in clinical practice (adapted from Roselló et al. 2017and Cancer Care Ontario 2019²²). BSA, body surface area; IRR, infusion-related reaction; i.v., intravenous; LOC, level of consciousness; PO, oral administration; PRN, as the situation demands; SOB, shortness of breath.