A protocol for pre-treatment testing for antibodies to galactose-alpha-1,3-galactose to mitigate the risk of cetuximab hypersensitivity reactions – a retrospective cohort review
Hypersensitivity reactions (HSRs) limit cetuximab use in KRAS wildtype advanced colorectal cancer, with a significant driver being pre-formed IgE antibodies against galactose-1,3-alpha-galactose (alpha-gal). Our multicentric retrospective study assessed the impact of prospective alpha-gal antibody screening on HSR incidence following cetuximab administration. Of 254 assessable patients, pre-treatment alpha-gal antibody screening significantly reduced the incidence of cetuximab HSRs (3% vs 16%; OR 0.14, p=0.02). Our findings support pre-treatment alpha-gal screening to improve safety of cetuximab therapy in high-risk populations.
Authors
- CC Mok
- Madhawa De Silva
- Joe Wei (ORCID: https://orcid.org/0000-0003-1944-1079)
- David Lok Hang Chan (ORCID: https://orcid.org/0000-0002-7773-3144)
- Sheryl van Nunen (ORCID: https://orcid.org/0000-0001-8192-7008)
- Connie I. Diakos (ORCID: https://orcid.org/0000-0002-8877-3440)
- Amanda L. Hudson (ORCID: https://orcid.org/0000-0002-8275-0395)
- Alexander Yuile (ORCID: https://orcid.org/0000-0002-7242-0528)
- Gavin M. Marx (ORCID: https://orcid.org/0000-0002-1016-6544)
- Samuel Miller (ORCID: https://orcid.org/0000-0002-6013-5471)
- Stephen John Clarke (ORCID: https://orcid.org/0000-0001-5817-1222)
- Thomas Skinner (ORCID: https://orcid.org/0000-0002-7171-1040)
- Nick Pavlakis (ORCID: https://orcid.org/0000-0002-1738-0316)
- Meredith Oatley (ORCID: https://orcid.org/0000-0002-2644-5695)
- Nicholas Della Marta
Institutions
- The University of Sydney (AU)
- Sydney Adventist Hospital (AU)
- Royal North Shore Hospital (AU)
- Cancer Institute of New South Wales (AU)
- Northern Sydney Local Health District (AU)
- Northern Cancer Institute (AU)
Publication Details
- Journal
- Cancer Treatment and Research Communications
- Published
- 2025-01-01
- DOI
- https://doi.org/10.1016/j.ctarc.2025.100969
- Primary Topic
- Drug-Induced Adverse Reactions
- Type
- article
- Field-Weighted Citation Impact
- 0.00