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<p>Temozolomide (TMZ) is an oral alkylating agent used in the first-line treatment regimen for glioblastoma (GBM) and other high-grade gliomas, with demonstrated improvement in survival outcomes. Dermatological hypersensitivity reactions are uncommon, however when severe can halt further use of TMZ. We describe a case of a 25-year-old female with GBM who developed recurrent cutaneous hypersensitivity reactions to TMZ, including diffuse urticarial lesions and pruritus. A rapid desensitization protocol using only commercially available TMZ capsules (5&#xa0;mg, 20&#xa0;mg, and 100&#xa0;mg) was successfully implemented, enabling continuation of treatment without the need for complicated compounding or dilution. The desensitization protocol was initially administered in a monitored clinical setting and subsequently adapted for home use, improving feasibility and adherence. This case demonstrates that TMZ desensitization using standard dosage forms is a viable strategy to overcome hypersensitivity, allowing patients to maintain optimal GBM therapy.</p>

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Novel desensitization protocol utilizing conventional formulations to mitigate Temozolomide-Related skin hypersensitivity

  • 期刊论文

  • 发表日期：

    2025年6月20日

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  • Morgan E. Cantley,
  • Clyde Coleman,
  • Rachael M. Morgan,
  • Niharika Reddy,
  • Sarah A. Sertich,
  • John L. Villano

摘要

Temozolomide (TMZ) is an oral alkylating agent used in the first-line treatment regimen for glioblastoma (GBM) and other high-grade gliomas, with demonstrated improvement in survival outcomes. Dermatological hypersensitivity reactions are uncommon, however when severe can halt further use of TMZ. We describe a case of a 25-year-old female with GBM who developed recurrent cutaneous hypersensitivity reactions to TMZ, including diffuse urticarial lesions and pruritus. A rapid desensitization protocol using only commercially available TMZ capsules (5 mg, 20 mg, and 100 mg) was successfully implemented, enabling continuation of treatment without the need for complicated compounding or dilution. The desensitization protocol was initially administered in a monitored clinical setting and subsequently adapted for home use, improving feasibility and adherence. This case demonstrates that TMZ desensitization using standard dosage forms is a viable strategy to overcome hypersensitivity, allowing patients to maintain optimal GBM therapy.