Reactions 1134 - 13 Jan 2007

SCetuximab

Allergy: 2 case reportsA 68-year-old woman and a 57-year-old man developed an

allergy during treatment with cetuximab for irinotecan- andoxaliplatin- resistant metastatic colorectal cancer.

The woman started receiving cetuximab weekly [dose notstated], as well as clemastine prior to each dose. Shedeveloped generalised urticaria and severe hypotension (BP61/50mm Hg) 30 minutes after initiation of the loading dose ofcetuximab. Treatment was stopped immediately and sherecovered promptly after receiving clemastine. She wasrechallenged with cetuximab 1 week after informed consentwas obtained. For this rechallenge, she was premedicated withclemastine and prednisolone, and the cetuximab infusion ratewas gradually increased from 10% of the original infusion rateuntil it reached the initial infusion rate; she did not experienceany allergy. This treatment regimen was continued. A CT scanconducted 9 weeks later revealed progressive disease and,therefore, treatment was stopped.

The man also started receiving cetuximab weekly [dose notstated], as well as clemastine prior to each dose. He developedbradycardia (pulse rate 46), severe hypotension (BP74/39mm Hg), dyspnoea, pruritus and a slightly blurredconsciousness 35 minutes after initiation of the loading doseof cetuximab. Treatment was stopped instantly and hereceived epinephrine [adrenaline] and clemastine. Heresponded with tachycardia, breast pain, tremor, an increasein BP and his breathing normalised. One hour later, heexperienced a generalised blazing, bright red, urticariaparticularly localised on his breast, back and face, whichremained for 8 hours. Taking into consideration the previouswoman’s experience, 1 week after informed consent wasobtained, he was also rechallenged. He received the sametreatment regimen as the woman and did not experienceallergy. Following nine cetuximab series, a CT scan wasconducted which revealed a partial response. At last follow-up,he was still receiving cetuximab.Nielsen DL, et al. Re-treatment with cetuximab in patients with severehypersensitivity reactions to cetuximab. Two case reports. Acta Oncologica 45:1137-1138, No. 8, Dec 2006 - Denmark 801059518

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Reactions 13 Jan 2007 No. 11340114-9954/10/1134-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved