| Title: | Basophil activation test predicts cetuximab anaphylaxis severity in alpha-gal IgE-positive patients |
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| Authors: | ID Kopač, Peter, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Koren, Ana, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Bidovec, Urška, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Košnik, Mitja, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Dejanović, Luka, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Mesti, Tanja, Onkološki inštitut Ljubljana (Author)
ID Strojan, Primož, Onkološki inštitut Ljubljana (Author)
ID Korošec, Peter, Univerzitetna klinika za pljučne bolezni in alergijo Golnik (Author)
ID Ocvirk, Janja, Onkološki inštitut Ljubljana (Author) |
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| Files: |  URL - Source URL, visit https://www.mdpi.com/2075-4418/14/13/1403
 PDF - Presentation file, download (768,48 KB)
MD5: B0BC46E13AAF68E3295B7020DA5956FB
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
 OI - Institute of Oncology
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| Abstract: | 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. |
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| Keywords: | alpha-gal, baseline serum tryptase, basophil activation test, cetuximab, drug allergy |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Submitted for review: | 10.05.2024 |
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| Article acceptance date: | 26.06.2024 |
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| Publication date: | 01.07.2024 |
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| Year of publishing: | 2024 |
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| Number of pages: | str. [1]-11 |
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| Numbering: | Vol. 14, issue 13, [article no.] 1403 |
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| PID: | 20.500.12556/DiRROS-23077  |
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| UDC: | 61 |
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| ISSN on article: | 2075-4418 |
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| DOI: | 10.3390/diagnostics14131403 |
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| COBISS.SI-ID: | 201818371 |
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| Copyright: | © 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/). |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 15. 7. 2024;
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| Publication date in DiRROS: | 22.07.2025 |
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| Views: | 570 |
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| Downloads: | 260 |
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