Metal-Based Drugs skin testing to identify patients at risk and reported a 99% negative predictive value. It seems that skin tests are positive in more than 80% of reactive patients and that when they are negative, the risk of hypersensitivity reactions is reduced sevenfold or even eliminated [30, 78]. Therefore, it has been recommended that skin testing is performed in every patient before administration of the eighth dose. Skin testing can prove helpful in an eﬀort to rule out cross-reactions when one platinum salt is substituted by another [100, 104, 105]. More speciﬁcally, patients testing negative for cross-reaction in skin tests seem to be able to safely continue chemotherapy with a diﬀerent platinum compound. Platinum-based treatment is safely administered without need of pretreatment, and this can prove useful in patients with contraindications to prolonged corticosteroid exposure [102]. It should be noted that patients with positive skin tests were also more likely to exhibit hypersensitivity reactions during desensitization protocols as compared to patients with negative skin tests [52]. The usefulness of skin testing in everyday clinical setting remains an issue of controversy. It does not seem practical to use it as a routine screening test in all patients retreated. It requires prior experience and use of a control. Furthermore, hypersensitivity reactions might still occur even in case of negative skin tests. However, many experts support that skin testing can be extremely helpful when the expected prevalence of hypersensitivity is high. There is need for larger studies in the future in order to clarify the role of skin testing and to establish proper guidelines. As far as oxaliplatin hypersensitivity is concerned, pre- treatment regimens with corticosteroids, antihistamines, and extension of administration time have been somewhat successful but their reliability has not yet been proven [63, 84, 91, 106–108]. Brandi et al. [107] and Sui et al. [109] reintroduced oxaliplatin in patients having received prophylactic Dexamethasone and antihistamines but hyper- sensitivity recurred in a signiﬁcant number of patients. Similar data were reported by two Japanese retrospective studies [45, 73]. Oxaliplatin desensitization protocols have been reported in a very small number of patients [15, 56, 58–66, 110] with the total infusion time ranging from 2 to 24 hours (Table 6). Better response rates and longer time-to-progression were observed with chronomodulated (10 am−10 pm) oxaliplatin infusion [111]. Wrzensinski et al. added magnesium sulfate and calcium gluconate to a previously published protocol and suggested that this may increase the success rate of desensitization [60]. Skin testing for oxaliplatin is 75% to 80% accurate according to Meyer et al. [110] and Garuﬁ et al. [112]. 7. Conclusions Platinum-induced hypersensitivity reactions are a potentially fatal complication that occurs at a rising incidence rate due to the growing use of these agents in chemotherapy. The clinical symptoms range from a mild rash to severe anaphylaxis, and multiple types of hypersensitivity seem to be implicated. Doctors as well as patients should be 7 appropriately educated to promptly recognize symptoms. In case of severe anaphylactic reactions, platinum-based treat- ment is usually completely discontinued. 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