Researchers find cause of severe allergic reaction to c...( Clinicians have been perplexed by th...),Health

Clinicians have been perplexed by the fact that some patients given the drug cetuximaban immune-based therapy commonly used to treat persons diagnosed with head and neck cancer, or colon cancerhave a severe and rapid adverse reaction to the drug. Sometimes the reaction includes anaphylaxis, a life-threatening condition characterized by a drop in blood pressure, fainting, difficulty breathing, and wheezing. Now researchers funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have discovered that specific pre-existing antibodies cause the severe reaction to the drug. This discovery in turn has enabled them to explain the unusual geographic pattern of this reaction seen among individuals in the United States. The unusual findings of this investigation appear in a report published in the March 13 edition of the New England Journal of Medicine.

These intriguing research findings not only are potentially important to physicians treating certain cancer patients, but also may have broader implications for the use of immunotherapies for other diseases, notes Anthony S. Fauci, M.D., NIAID director.

NIAID grantee Thomas Platts-Mills, M.D., Ph.D., who heads the Division of Allergy and Clinical Immunology at the University of Virginia, led a research study to investigate the cause of the clinical problem with cetuximab. Their newly reported findings are of immediate importance in the care of cancer patients, says Dr. Platts-Mills. Because of the widespread use of cetuximab in cancer treatment, it may be useful to pre-screen patients for specific IgE antibodies to cetuximab to identify those who are at risk for serious adverse reactions, including anaphylaxis.

Cetuximab is a partially humanized mouse monoclonal antibody, which means it is produced by a single cell line and acts against a specific protein. The drug inhibits a growth factor receptor found on the cell surface, thereb
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