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Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose.

Publication ,  Journal Article
Chung, CH; Mirakhur, B; Chan, E; Le, Q-T; Berlin, J; Morse, M; Murphy, BA; Satinover, SM; Hosen, J; Mauro, D; Slebos, RJ; Zhou, Q; Gold, D ...
Published in: N Engl J Med
March 13, 2008

BACKGROUND: Cetuximab, a chimeric mouse-human IgG1 monoclonal antibody against the epidermal growth factor receptor, is approved for use in colorectal cancer and squamous-cell carcinoma of the head and neck. A high prevalence of hypersensitivity reactions to cetuximab has been reported in some areas of the United States. METHODS: We analyzed serum samples from four groups of subjects for IgE antibodies against cetuximab: pretreatment samples from 76 case subjects who had been treated with cetuximab at multiple centers, predominantly in Tennessee, Arkansas, and North Carolina; samples from 72 control subjects in Tennessee; samples from 49 control subjects with cancer in northern California; and samples from 341 female control subjects in Boston. RESULTS: Among 76 cetuximab-treated subjects, 25 had a hypersensitivity reaction to the drug. IgE antibodies against cetuximab were found in pretreatment samples from 17 of these subjects; only 1 of 51 subjects who did not have a hypersensitivity reaction had such antibodies (P<0.001). IgE antibodies against cetuximab were found in 15 of 72 samples (20.8%) from control subjects in Tennessee, in 3 of 49 samples (6.1%) from northern California, and in 2 of 341 samples (0.6%) from Boston. The IgE antibodies were shown to be specific for an oligosaccharide, galactose-alpha-1,3-galactose, which is present on the Fab portion of the cetuximab heavy chain. CONCLUSIONS: In most subjects who had a hypersensitivity reaction to cetuximab, IgE antibodies against cetuximab were present in serum before therapy. The antibodies were specific for galactose-alpha-1,3-galactose.

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Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

March 13, 2008

Volume

358

Issue

11

Start / End Page

1109 / 1117

Location

United States

Related Subject Headings

  • Protein Conformation
  • Protein Binding
  • Middle Aged
  • Male
  • Immunoglobulin E
  • Humans
  • General & Internal Medicine
  • Female
  • ErbB Receptors
  • Epitopes
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chung, C. H., Mirakhur, B., Chan, E., Le, Q.-T., Berlin, J., Morse, M., … Platts-Mills, T. A. E. (2008). Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose. N Engl J Med, 358(11), 1109–1117. https://doi.org/10.1056/NEJMoa074943
Chung, Christine H., Beloo Mirakhur, Emily Chan, Quynh-Thu Le, Jordan Berlin, Michael Morse, Barbara A. Murphy, et al. “Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose.N Engl J Med 358, no. 11 (March 13, 2008): 1109–17. https://doi.org/10.1056/NEJMoa074943.
Chung CH, Mirakhur B, Chan E, Le Q-T, Berlin J, Morse M, et al. Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose. N Engl J Med. 2008 Mar 13;358(11):1109–17.
Chung, Christine H., et al. “Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose.N Engl J Med, vol. 358, no. 11, Mar. 2008, pp. 1109–17. Pubmed, doi:10.1056/NEJMoa074943.
Chung CH, Mirakhur B, Chan E, Le Q-T, Berlin J, Morse M, Murphy BA, Satinover SM, Hosen J, Mauro D, Slebos RJ, Zhou Q, Gold D, Hatley T, Hicklin DJ, Platts-Mills TAE. Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose. N Engl J Med. 2008 Mar 13;358(11):1109–1117.

Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

March 13, 2008

Volume

358

Issue

11

Start / End Page

1109 / 1117

Location

United States

Related Subject Headings

  • Protein Conformation
  • Protein Binding
  • Middle Aged
  • Male
  • Immunoglobulin E
  • Humans
  • General & Internal Medicine
  • Female
  • ErbB Receptors
  • Epitopes