20.500.12556/DiRROS-23077 Basophil activation test predicts cetuximab anaphylaxis severity in alpha-gal IgE-positive patients Upon first exposure to cetuximab, hypersensitivity reactions can occur. We aimed to assess the utility of the basophil activation test (BAT) to alpha-gal and cetuximab for predicting severe reactions. We prospectively recruited 38 patients and evaluated sIgE to alpha-gal in all patients before the first application of cetuximab. In all alpha-gal-sensitized patients, we evaluated skin tests to meat extracts, gelatine, and cetuximab and performed BAT with alpha-gal and cetuximab. In 24% (9/38) of patients, sIgE to alpha-gal was >0.10 kUA/L, and 8/9 reacted to the cetuximab. Basophil activation tests with alpha-gal were positive in all sensitized patients and were higher in those with severe reactions (18.3% in grade 4 [n = 4] vs. 1.8% in grade 2 [n = 3] or no reaction [n = 1] at 3.3 ng/mL of alpha-gal; p = 0.03). All patients with severe grade 4 reactions had a positive CD63 BAT response to cetuximab compared to patients with moderate or no reaction, who all had negative BAT (57.7% vs. 0.9% at 500 µg/mL, 63.2% vs. 4.1% at 100 µg/mL, 58.2% vs. 2.7% at 10 µg/mL, and 32.1% vs. 3.3% at 1 µg/mL of cetuximab, respectively; p ≤ 0.001). In summary, before initiating cetuximab treatment, sIgE to alpha-gal should be assessed in all patients. To predict the severity of the reaction and to assess the risk of cetuximab-induced anaphylaxis, we should perform BATs with alpha-gal or more discriminative BATs with cetuximab. alpha-gal baseline serum tryptase basophil activation test cetuximab drug allergy alfa-gal izhodiščna koncentracija triptaze v serumu test aktivacije bazofilcev alergija na zdravilo true false true Angleški jezik Slovenski jezik © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Neznano 2025-07-22 10:17:47 2025-07-22 10:17:47 2025-10-24 03:53:05 0000-00-00 00:00:00 2024 0 0 Nasl. z nasl. zaslona; Opis vira z dne 15. 7. 2024; str. [1]-11 issue 13, [article no.] 1403 Vol. 14 2024 0000-00-00 Zaloznikova Objavljeno apc 2024-05-10 2024-06-26 2024-07-01 61 2075-4418 10.3390/diagnostics14131403 201818371 https://www.mdpi.com/2075-4418/14/13/1403 1 5aa0bfb0-66d4-11f0-9bb7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=33823 RAZ_Kopac_Peter_2024.pdf RAZ_Kopac_Peter_2024.pdf 1 B0BC46E13AAF68E3295B7020DA5956FB 0067e1efa5b0bc25a10f46797fdb4e14f584a251e47a067664fb67ecb1104fc2 e9d8aef6-66d4-11f0-9bb7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=33824 Univerzitetna klinika za pljučne bolezni in alergijo Golnik Onkološki inštitut Ljubljana 0 0 0