A case of aseptic meningitis in a cetuximab-experienced patient with metastatic colon cancer

Rohrer, Chelsea L; Grullon, Zunilda; George, Sarah K; Castillo, Raul; Karasiewicz, Kelli

doi:10.1177/1078155217739685

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…The only reported case of aseptic meningitis in a patient with metastatic colon cancer was associated with the lower dose of 250 mg/m 2 . In contrast to all other reported cases, aseptic meningitis occurred after the 12th administration of cetuximab [3]. No premedication with glucocorticoids was reported before the respective cetuximab application (see Table 1).…”

Section: Discussionmentioning

confidence: 76%

“…We report on a case of clinically pronounced aseptic meningitis within hours after the first cetuximab treatment with a dosage of 400 mg/m 2 in a patient with metastatic colorectal cancer, followed by fast and full recovery within 2 days. So far, few cases of aseptic meningitis related to a previous administration of cetuximab have been reported (see Table 1 ) [ 1 , 3 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Here, a higher dose (400 mg/m 2 ) is administered, while in consecutive administrations, 250 mg/m 2 is recommended. One case of aseptic meningitis was found in a patient with metastatic colorectal cancer after the 12th administration of cetuximab at the lower dosage (250 mg/m 2 ) [ 3 ]. Even if clinical symptoms and CSF findings suggest severe bacterial meningitis, the course of cetuximab-induced aseptic meningitis is benign and self-limited within a few days.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cetuximab-Induced Aseptic Meningitis in a Patient with Colorectal Cancer: A Case Report and Review of Literature

et al. 2022

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Cetuximab is a chimeric IgG1 monoclonal antibody against epidermal growth factor receptor. It is approved by the European medical agency for the treatment of RAS wild-type metastatic colorectal cancer and metastatic squamous cell cancer of the head and neck. Few cases of aseptic meningitis, primarily associated with the first administration of cetuximab in patients with squamous cell cancer, have been reported. So far, there was only 1 case in a patient with metastatic colorectal cancer. We report on a 50-year-old Caucasian patient with metastatic rectum carcinoma who suffered from headache, fever, and neck stiffness 3 h after the first administration of cetuximab (400 mg/m<sup>2</sup>). CSF examination revealed an excessive pleocytosis with a white blood cell count of 2,433/µL. He was diagnosed with cetuximab-induced aseptic meningitis since clinical symptoms and CSF pleocytosis resolved within days, and further diagnostic workup revealed no infectious cause. Cetuximab-induced aseptic meningitis is a rare and severe drug reaction with predominance in treating squamous cell cancer of the head and neck. Clinical presentation and CSF findings suggest acute meningoencephalitis. In all reported cases, the course of the disease was benign and self-limited. Empiric antimicrobial and antiviral therapy are suggested until infectious causes can be ruled out. A lower dosage of cetuximab and a premedication including antihistamines and glucocorticosteroids may lower the risk of a re-occurrence if cetuximab therapy is continued.

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Section: Discussionmentioning

confidence: 76%