Assay May Be Used to Predict Anaphylaxis in Cetuximab-treated Patients

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The presence of preformed immunoglobulin E antibodies against galactose-α-1,3-galactose in serum may be used to predict anaphylaxis.
The presence of preformed immunoglobulin E antibodies against galactose-α-1,3-galactose in serum may be used to predict anaphylaxis.

The presence of preformed immunoglobulin E antibodies against galactose-α-1,3-galactose in serum may be used to predict anaphylaxis in response to cetuximab, according to a study published in Cancer.1

Cetuximab, a monoclonal antibody that acts against epidermal growth factor receptor, has activity against head and neck cancer and colorectal cancer. Treatment-related anaphylaxis is a significant problem in the Southeastern United States with a grade 3/4 infusion reaction rate of 14%.

Investigators sought to confirm previous retrospective data that suggested that the presence of preformed immunoglobulin E antibodies against galactose- α-1,3-galactose in serum can predict anaphylaxis.

A total of 60 patients were prospectively screened as part of the entry criteria for a phase 2 study of neoadjuvant carboplatin, nab-paclitaxel, and cetuximab. Patients were recruited from 2 medical centers known to have high anaphylactic rates in North Carolina. Only those patients with a negative laboratory result were treated on the clinical protocol.

RELATED: Adding Cetuximab to FOLFIRI Improved Response in Both Younger, Older Patients with mCRC

Results showed that the negative predictive value was 100%; no assay-negative patient experienced anaphylaxis.

“Further research is required regarding the optimal cutoff for positivity and the positive predictive value,” the study authors concluded.

Reference

  1. Weiss J, Olson JG, Deal AM, et al. Using the galactose-α-1,3-galactose enzyme-linked immunosorbent assay to predict anaphylaxis in response to cetuximab [published online ahead of print]. Cancer. doi: 10.1002/cncr.29978.

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