Managing premedications and the risk for reactions to infusional monoclonal antibody therapy.

摘要: Monoclonal antibodies-including rituximab, alemtuzumab, trastuzumab, bevacizumab, cetuximab, and panitumumab-have improved the treatment of various malignancies. Although generally better tolerated with less toxicity than conventional anticancer agents, monoclonal antibodies may cause infusion-related reactions like other infusional agents. The incidence infusion varies by agent, but severe events occur only occasionally, mostly first or second infusion. exact etiology remains unclear, they arise via either IgE- non-IgE-dependent mechanisms. There is a compelling clinical need to improve risk assessment for reactions. recent identification pre-existing IgE crossreacting its association reactions, regional variation in prevalence provide marker high-risk assessment. Premedication antihistamines, acetaminophen, and/or corticosteroids common practice prevent all antibodies. However, observational study suggests that premedication no longer be necessary after cetuximab if patients did not develop any symptoms two infusions. Considering heterogeneity clinicians recognize underlying nature these order identify at as well optimal prophylactic measures management symptoms.