Successful desensitization with cetuximab after an infusion reaction to panitumumab in patients with metastatic colorectal cancer

Saif, Muhammad Wasif; Syrigos, Kostas; Hotchkiss, Sara C.; Shanley, Jemma; Grasso, J. A.; Ferencz, T.; Syrigos, Kostas; Shah, Mudasir Ahmad

doi:10.1007/s00280-009-1009-6

Cited by 19 publications

(14 citation statements)

References 19 publications

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“…The lower incidence with panitumumab as compared with cetuximab is likely due to panitumumab being a fully humanized antibody (81). The mechanisms of infusion and hypersensitivity reactions to the two antibodies may differ, and cases of successful treatment with panitumumab after severe hypersensitivity to cetuximab, as well as vice versa, have been described (82)(83)(84).…”

Section: Infusion Reactionsmentioning

confidence: 99%

Biological agents in gastrointestinal cancers: adverse effects and their management

Arora¹,

Gupta²,

Singh³

2017

J. Gastrointest. Oncol.

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Biological therapy comprises agents that by virtue of their unique mechanisms of action, are able to specifically incite a response against or target malignant cells. They differ from conventional chemotherapy with regard to mechanisms of action, indications and side effect profile. Biologic agents have revolutionized therapy for a number of malignancies. In the setting of gastrointestinal (GI) malignancies, agents targeting vascular endothelial growth factor (VEGF), human epidermal growth factor receptor 2 (Her2/Neu) and epidermal growth factor receptor (EGFR) have proven to be invaluable additions to chemotherapy. However, these agents bring with them a set of side effects attributable to their unique mechanisms of action. The anti VEGF agents-bevacizumab, aflibercept and ramucirumab, can result in renal and vascular complications such as hypertension, arterial thrombotic events (ATE), proteinuria and GI perforations. The anti EGFR agents classically cause dermatological toxicities, in addition to hypomagnesemia, which can be dose limiting for patients. Trastuzumab, a monoclonal antibody that targets Her2/Neu, is known to cause cardiotoxicity, especially when used with anthracyclines. Use of immunotherapy agents such as nivolumab is associated with the development immune related adverse events (irAEs). The use of these agents is expected to increase over the next few years and it is crucial that patients and practitioners are aware of their adverse effects and current management strategies. This review highlights the adverse events associated with the use of biologic and immunologic therapies in GI cancers, their incidence and current management strategies.

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Section: Infusion Reactionsmentioning

confidence: 99%

Biological agents in gastrointestinal cancers: adverse effects and their management

Arora¹,

Gupta²,

Singh³

2017

J. Gastrointest. Oncol.

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“…Successful desensitization protocols are usually time-consuming [30, 32, 33, 38, 50, 53–57, 89–91]. Prolonged desensitization is probably more tolerable when considering the changes caused in the extracellular fluid drug concentration rate [94]. However, rapid protocols that develop desensitization within 4–8 hours have also been attempted [78].…”

Section: Treatment Strategiesmentioning

confidence: 99%

Hypersensitivity Reactions Associated with Platinum Antineoplastic Agents: A Systematic Review

et al. 2010

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Platinum-containing chemotherapy agents (cisplatin, carboplatin, oxaliplatin) have been approved in the first-line setting of numerous malignancies, such as ovarian, bladder, head and neck, colorectal, and lung cancer. Their extensive use over the last decade has led to a significant increase in the incidence of hypersensitivity reactions, which are defined as unforeseen reactions whose signs and symptoms cannot be explained by the known toxicity of these drugs. Skin rash, flushing, abdominal cramping, itchy palms, and back pain are common symptoms. Cardiovascular and respiratory complications can prove fatal. Multiple pathogenetic mechanisms have been suggested. Hypersensitivity usually appears after multiple infusions, suggesting type I allergic reactions; however, other types of hypersensitivity also seem to be implicated. Several management options are available to treating physicians: discontinuation of chemotherapy, premedication, prolonging of infusion duration, desensitization protocols, and replacement with a different platinum compound after performing skin tests that rule out cross-reactions among platinum agents.

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“…Saif et al described two mCRC patients with severe infusion reactions to panitumumab who were successfully challenged with cetuximab99, and three patients with severe hypersensitivity reactions to cetuximab who were successfully challenged with panitumumab100. The two patients who were switched to cetuximab received premedication with prednisone and antihistamines, and were treated with cetuximab according to a prolonged infusion time and gradual dose escalation99. None of the three patients successfully switched to panitumumab received pretreatment100.…”

Section: Infusion Reactionsmentioning

confidence: 99%

Systemic Therapies in Metastatic Non-Small-Cell Lung Cancer with Emphasis on Targeted Therapies: The Rational Approach

Hirsh

2010

Current Oncology

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The epidermal growth factor receptor (EGFR), a member of the ErbB family of receptor tyrosine kinases, plays an important role in the control of cell growth and differentiation. Disruption of its signaling leads to neoplastic cell proliferation, migration, stromal invasion, resistance to apoptosis, and angiogenesis.EGFR is overexpressed in a variety of solid tumors, including colorectal cancer (CRC), and its overexpression is associated with poorer prognosis. One class of agents that is currently used to target EGFR in the treatment of metastatic CRC (mCRC) is the monoclonal antibodies. While the monoclonal antibody EGFR inhibitors lack many of the severe side effects commonly observed with cytotoxic chemotherapy, they are associated with a set of unique dermatological toxicities. This paper reviews the safety profile of the anti-EGFR monoclonal antibodies cetuximab and panitumumab in the treatment of mCRC. KEY WORDSepidermal growth factor receptor, skin toxicity, cetuximab, panitumumab

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Successful desensitization with cetuximab after an infusion reaction to panitumumab in patients with metastatic colorectal cancer

Cited by 19 publications

References 19 publications

Biological agents in gastrointestinal cancers: adverse effects and their management

Biological agents in gastrointestinal cancers: adverse effects and their management

Hypersensitivity Reactions Associated with Platinum Antineoplastic Agents: A Systematic Review

Systemic Therapies in Metastatic Non-Small-Cell Lung Cancer with Emphasis on Targeted Therapies: The Rational Approach

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