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