Journal List > Allergy Asthma Respir Dis > v.3(4) > 1059115

Won, Moon, Shim, Chung, Kim, Kim, Park, and Kang: Successful rapid desensitization for cetuximab-induced anaphylaxis

Abstract

Cetuximab, a chimeric mouse-human immunoglobulin, is an antiepidermal growth factor receptor monoclonal antibody. It has been approved by the U.S. Food and Drug Administration for the treatment of metastatic colorectal and head/neck cancer, but can cause fatal hypersensitivity reactions in some patients. A 66-year-old male with metastatic sigmoid cancer had cetuximab-induced anaphylaxis when the first dose of cetuximab was administered. Cetuximab was safely readministered for another 15 cycles based on the rapid desensitization protocol. We experienced a case of cetuximab-induced anaphylaxis on the first exposure which was successfully managed by rapid desensitization.

Figures and Tables

Table 1

The preparation of 4-bottle tenfold increasing solutions used in the rapid 12-step desensitization protocol in the present case of the cetuximab-induced delayed hypersensitivity

aard-3-294-i001
Solution Concentration (mg/mL) Rate (mL/hr) Duration (min) Dose (mg) Volume (mL)
1:1,000 0.00169 100 20.0 0.06 33.3
0.00169 220 15.0 0.09 55.0
0.00169 480 16.7 0.23 133.7
1:100 0.01708 100 20.0 0.57 33.3
0.01708 210 15.0 0.90 52.5
0.01708 450 15.2 1.95 114.2
1:10 0.17235 100 20.0 5.75 33.3
0.17235 210 15.0 9.05 52.5
0.17235 450 15.2 19.68 114.2
1:1 1.73913 100 20.0 57.97 33.3
1.73913 170 15.0 73.91 42.5
1.73913 300 26.4 229.86 132.2

Notes

This study was supported by a grant from Ministry of Food and Drug Safety to operation of the Regional Pharmacovigilance Center in 2015.

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