Successful desensitization of a patient with cetuximab hypersensitivity: A case report

Solduzian, Mohammad; Anvari, Saeed; Masoumi, Hamidreza Taghvaye; Shahi, Farhad; Jahangard‐Rafsanjani, Zahra

doi:10.1177/1078155218793505

Cited by 6 publications

(3 citation statements)

References 22 publications

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“…When performed, it should be justified by suboptimal carcinological outcomes, after drug desensitization. In previous studies, several desensitization protocols were developed to safely carry on using cetuximab [54][55][56][57][58][59][60]. Despite this fact, no desensitization procedure was performed in our study and definitive discontinuation of cetuximab was decided for all patients that experienced severe CI-IRs.…”

Section: Discussionmentioning

confidence: 97%

Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: A possible association with Lyme disease?

Dupont

Carlier

Gower‐Rousseau

et al. 2022

Preprint

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Background Previous studies have observed an increased incidence of Cetuximab-induced hypersensitivity infusion reactions (CI-IRs) in the southeastern states of the USA. Tick’s bites were suspected of generating cross-reactions between cetuximab and alpha-gal. This study aims was to describe the incidence and associated risk factors of CI-IRs, in the French areas chosen according to their Lyme disease incidence.Patients and methods A retrospective chart review was conducted on patients that received cetuximab infusion from January 2010 to June 2019 in 4 French areas with different Lyme disease incidence rates. Results Of 1392 patients, 117 (8.4%) experienced a CI-IR, including 68 severe (grade 3 or 4) reactions (4.9%). This CI-IR incidence was significantly higher in the Lyme disease high-risk area than in the other areas (13.2% versus 7.1%, 8.1% and 6.4%; P=0.016). Sex (P=0.53), premedication (P=0.91), primary cancer location (P=0.46) and chemotherapy regimen type (P=0.78) had no impact on CI-IR incidence in the overall population. In the head and neck squamous cell carcinoma (HNSCC) patient subgroup, CI-IRs were significantly more frequent in the high-risk area (16.4% versus 6.7%, 7.1% and 7.0%; P=0.0015). ConclusionThis study suggests that patients treated in the French area with the highest incidence of Lyme disease are at a higher risk of CI-IRs.

show abstract

Section: Discussionmentioning

confidence: 97%

Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: A possible association with Lyme disease?

Dupont

Carlier

Gower‐Rousseau

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…When performed, it should be justified by suboptimal carcinological outcomes, after drug desensitization. In previous studies, several desensitization protocols were developed to safely carry on using cetuximab [ 54 – 60 ]. Despite this fact, no desensitization procedure was performed in our study and definitive discontinuation of cetuximab was decided for all patients that experienced severe CI-IRs.…”

Section: Discussionmentioning

confidence: 99%

Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: a possible association with Lyme disease?

et al. 2022

View full text Add to dashboard Cite

Background: Previous studies have observed an increased incidence of Cetuximab-induced hypersensitivity infusion reactions (CI-IRs) in the southeastern states of the USA. Tick’s bites were suspected of generating cross-reactions between cetuximab and alpha-gal. This study aims was to describe the incidence and associated risk factors of CI-IRs, in the French areas chosen according to their Lyme disease incidence. Patients and methods: A retrospective chart review was conducted on patients that received cetuximab infusion from January 2010 to June 2019 in 4 French areas with different Lyme disease incidence rates. Results: Of 1392 patients, 117 (8.4%) experienced a CI-IR, including 68 severe (grade 3 or 4) reactions (4.9%). This CI-IR incidence was significantly higher in the Lyme disease high-risk area than in the other areas (13.2% versus 7.1%, 8.1% and 6.4%; P = 0.016). Sex (P = 0.53), premedication (P = 0.91), primary cancer location (P = 0.46) and chemotherapy regimen type (P = 0.78) had no impact on CI-IR incidence in the overall population. In the head and neck squamous cell carcinoma (HNSCC) patient subgroup, CI-IRs were significantly more frequent in the high-risk area (16.4% versus 6.7%, 7.1% and 7.0%; P = 0.0015). Conclusion: This study suggests that patients treated in the French area with the highest incidence of Lyme disease are at a higher risk of CI-IRs.

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“… 9 Successful desensitization of patients who experienced cetuximab-induced anaphylaxis has been reported. 10 , 11 Advance prediction of HSR risk can help enable safe adherence to first-line cancer treatment, and improve treatment outcomes and quality of life in advanced cancer patients. Prediction can also reduce unnecessary medical costs.…”

Section: Discussionmentioning

confidence: 99%

Nationwide pharmacovigilance data for cetuximab-induced anaphylaxis and predictive model validation using prospective specific IgE detection

Park

Lee

Beom

et al. 2021

World Allergy Organization Journal

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Background Cetuximab (chimeric monoclonal antibody to human epidermal growth factor receptor) is used to treat colorectal and head and neck cancers. Due to cross-reactivity with galactose-α-1,3-galactose (alpha-gal), it can induce hypersensitivity even at first administration. We aimed to determine the incidence and clinical manifestation of cetuximab-induced anaphylaxis, and to establish a means of predicting its incidence in patients ahead of treatment. Methods Nationwide and single-center pharmacovigilance data from 2010 to 2017 were collected from the Korea Institute of Drug Safety-Korea Adverse Event Reporting System and Severance Regional Pharmacovigilance Center. Patients scheduled for cetuximab administration were enrolled prospectively. A skin prick test was carried out and serum IgE specific to cetuximab and cross-reactive allergens were measured. Reactions were monitored after cetuximab infusion. Results Over 8 years, there were 23 reports of anaphylaxis nationwide. In a single-center study, incidence of cetuximab-induced anaphylaxis was 1.1%. Most anaphylaxis occurred at first injection (93.3%), even under pretreatment with anti-allergic drugs. Four of 64 patients (6.3%) experienced severe anaphylaxis. The median cetuximab-specific IgE titer was 6.9 kU A /L in patients experiencing anaphylaxis and 0 kU A /L in those who did not (P < 0.001). The results of alpha-gal, beef sIgE, and cetuximab skin prick testing were similar to those of cetuximab sIgE. Patients who did not experience hypersensitivity were negative in all 4 allergy tests. Its positive and negative predictive values were 100%. Conclusions Specific IgE detection of cetuximab or alpha-gal can accurately predict cetuximab-induced anaphylaxis prior to first administration.

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Successful desensitization of a patient with cetuximab hypersensitivity: A case report

Cited by 6 publications

References 22 publications

Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: A possible association with Lyme disease?

Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: A possible association with Lyme disease?

Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: a possible association with Lyme disease?

Nationwide pharmacovigilance data for cetuximab-induced anaphylaxis and predictive model validation using prospective specific IgE detection

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