Cetuximab-Induced Anaphylaxis and IgE Specific for Galactose-α-1,3-Galactose

Immediate hypersensitivity reactions to the monoclonal antibody cetuximab, used for the treatment of colorectal cancer and cancer of the head and neck, were found to be associated with IgE antibodies against cetuximab. These antibodies were present in pretreatment serum and were specific for galactose-α-1,3-galactose on the heavy chain of the cetuximab monoclonal antibody. Immediate hypersensitivity reactions to the monoclonal antibody cetuximab were found to be associated with IgE antibodies against cetuximab. These antibodies were present in pretreatment serum. Recombinant monoclonal antibodies have an increasing role in the treatment of cancers, inflammatory bowel disease, rheumatoid arthritis, and asthma. 1 – 3 These agents can cause rapidly developing, severe hypersensitivity reactions. 4 – 7 Cetuximab (Erbitux, Bristol-Myers Squibb and ImClone Systems), a chimeric mouse–human IgG 1 monoclonal antibody against the epidermal growth factor receptor (EGFR), is approved for use in metastatic colorectal cancer and squamous-cell carcinoma of the head and neck. 2 , 6 , 8 – 10 According to the drug's product label, severe hypersensitivity reactions to cetuximab occur in 3% of patients. However, higher rates and clusters of cases have been reported in North Carolina, Arkansas, . . .