Incidence of cetuximab-related infusion reactions in oncology patients treated at the University of North Carolina Cancer Hospital.
OBJECTIVE
The primary purpose of this study was to determine the rate of infusion reactions to cetuximab in oncology patients treated at the University of North Carolina Cancer Hospital. Secondarily, we sought to evaluate predictors of grade 3-4 hypersensitivity, including geography.


METHODS
Data were collected by retrospective chart review for patients treated with cetuximab at the University of North Carolina Cancer Hospital between 15 November 2006 and 31 December 2010. Data were analyzed for occurrence of hypersensitivity reaction in 125 patients with various cancer types.


RESULTS
Of the 125 subjects, 31 (24.8%) experienced an infusion reaction of any grade. Of 125, 18 (14.4%) experienced a grade 3 or 4 reaction. The odds ratio for patients with an allergy history having a grade 3 or 4 reaction was 2.57 (95% CI 0.93 to 7.09, p = 0.07). Pretreatment with steroids was associated with absence of grade 3 or 4 reaction with an odds ratio of 0.21 (95% CI 0.05 to 0.83, p = 0.04). Mapping of reaction rates by county revealed higher rates in some of the more rural counties of North Carolina, however, statistical power was lacking.


CONCLUSIONS
Rates of hypersensitivity reaction at UNC are similar to rates seen in other areas of the southeastern United States and higher than in other regions of the United States and Europe. Rates of both hypersensitivity reactions and grade 3 to 4 hypersensitivity reactions have not substantially changed over time. Geography, allergy history, and perhaps smoking or cancer type may help predict who will react to cetuximab. Steroids should be strongly considered as premedication in addition to diphenhydramine.
University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA.
Karen
K
Keating
University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA.
Christine
C
Walko
University of North Carolina Gillings School of Global Public Health, Department of Biostatistics, Chapel Hill, NC, USA.
Briana
B
Stephenson
Indiana University Simon Center, Indianapolis, IN, USA.
Bert H
BH
O'Neil
University of North Carolina Lineberger Cancer Center, Chapel Hill, NC, USA jared_weiss@med.unc.edu.
Jared
J
Weiss
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002173:Cancer Care Facilities; D000068818:Cetuximab; D004342:Drug Hypersensitivity / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D009657:North Carolina / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068818:Cetuximab
Cetuximab; Erbitux; anaphylaxis; hypersensitivity reactions; oncology