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medRxiv PreprintsInternational30 October 2026

Plasma Metabolomics During Chemotherapy Desensitization: A Pilot Study

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Background: Rapid drug desensitization permits continued chemotherapy, but no validated blood measurement predicts breakthrough reactions during desensitization. Objective: To compare paired plasma metabolomic and lipidomic changes during chemotherapy desensitization with those in tolerant controls, and to describe breakthrough and omalizumab encounters. Methods: In this pilot study, 10 patients undergoing carboplatin or paclitaxel desensitization and four tolerant controls receiving standard infusions contributed 76 draws across 39 encounters (37 with paired pre- and post-infusion draws). Unt
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