Plasma Metabolomics During Chemotherapy Desensitization: A Pilot Study

In 10 patients undergoing carboplatin or paclitaxel desensitization, untargeted plasma metabolomics showed broad pre-to-post shifts (Holm-adjusted P = .04) but no allergy-specific paired signature.

• Why it matters: Breakthrough reactions during desensitization lack a validated blood measurement predictor, limiting risk monitoring and study design.
• What they did: The study collected 76 plasma draws across 39 encounters (37 paired pre/post) and used untargeted liquid chromatography-mass spectrometry in four modes, yielding 8,646 quality-filtered features; permutation testing with false discovery rate control compared patient-averaged paired changes from 27 allergic encounters versus four control encounters.
• The result: Pre-infusion profiles differed from controls in one mode (Holm-adjusted P = .02), montelukast was detected in all 33 allergic and no control pre-infusion draws, and no feature distinguished paired changes at a 5% false discovery rate.

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