Chung CH - In a review discussing managing premedications and risk for reactions to infusional monoclonal antibody therapy, it was concluded that considering the heterogeneity of infusion reactions, clinicians need to recognize the underlying nature of these events in order to identify pts at risk as well as provide optimal prophylactic measures and management of symptoms Methods
Although generally better tolerated with less toxicity than conventional anticancer agents, monoclonal antibodies may cause infusion-related reactions like other infusional agents
Incidence of infusion reactions varies by agent, but severe events occur only occasionally, mostly with the first or second infusion
Although the exact etiology of infusion reactions remains unclear, they may arise via either IgE- or non-IgE–dependent mechanisms
Results
There is a compelling clinical need to improve risk assessment for severe infusion reactions
Recent identification of pre-existing IgE crossreacting with cetuximab, its association with severe reactions, and regional variation in prevalence may provide a marker for high-risk assessment
Premedication with antihistamines, acetaminophen, and/or corticosteroids is a common practice to prevent infusion reactions with all monoclonal antibodies
A recent observational study suggests that premedication may no longer be necessary after the second infusion of cetuximab if pts did not develop any symptoms with the first 2 infusions
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