Abstract
20744 Background: Monoclonal antibodies (Mabs) targeting epidermal growth factor receptor (EGFR) are effective in treatment of metastatic colorectal cancer (mCRC). CET, a human-murine chimeric Mab targets EGFR. Even with premedication, CET can cause an HSR in select pts. In case of severe HSR, further therapy with CET is contraindicated, thus preventing these pts from receiving potentially beneficial anti-EGFR therapy. PAN is a fully human Mab also targets EGFR. To date, no human antihuman Ab have been detected, and unlike CET, HSR are infrequent, and no premedication is required. Safety of PAN in pts with a previous severe HSR with CET is not fully known. We present 3 pts with GI cancers who tolerated PAN without HSR after experiencing severe HSR to CET. Methods: 3 pts were challenged with standard dose of PAN (6mg/kg) after experiencing grade (g) 3 HSR to standard dose of CET and monitored very closely. 1st pt, a 58-yr-old M with mCRC developed g3 HSR during 8th dose of CET. 2nd pt, a 58-yr-old F with mCRC develpoed g3 HSR during 12th dose of CET. 3rd pt, a 61-yr-old M with pancreatic cancer experienced g3 HSR during loading dose of CET. Charts were reviewed to find prior allergy, including H1 blocker use, drug allergy, bee sting allergy, eczema, allergic reactive airways disease, or food allergy. Results: All pts were Caucasians with average age of 59 yr and no history of prior allergy. No pt received any premedication. 1st pt received PAN for 2 mths, 2nd pt was treated for 6 mths, and 3rd pt who was rechallenged 1 week after HSR to CET had a partial response after 6 mths. Conclusions: HSR are serious complications associated with modern Abs. In order to reduce incidence and severity of such reactions, newer generations of Mabs contain less or no mouse-specific protein sequences. Identification of individuals likely to develop severe and sometimes life-threatening HSR is challenging. Our report of 3 pts successfully treated with PAN after they had severe HSR to CET warrant further investigation. Summary of safety and response to re-challenge with PAN Case Age/Sex Diagnosis CET Dose Grade of HSR Time Interval Between CET and PAN PAN Dose Tolerance Duration of PAN Therapy 1 58/M CRC 250mg/kg G3 1 month 6mg/kg No HSR 2 months 2 58/F CRC 250mg/kg G3 3 months 6mg/kg No HSR 6 months 3 61/M Pancreatic cancer 400mg/kg G3 1 week 6mg/kg No HSR 6 months M: male, F: female No significant financial relationships to disclose.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call