Cetuximab hypersensitivity infusion reactions: Incidence and risk factors.
Cetuximab hypersensitivity infusion reactions: Incidence and risk factors.
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DOI：
10.1177/1078155212462440
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发表时间：
2013-09-01
期刊：
影响因子：
--
通讯作者：
Borders, Emily
中科院分区：
文献类型：
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作者：
Hopps, Sarah;Medina, Patrick;Borders, Emily
前言：西妥昔单抗是一种人-鼠嵌合(30：70)的单抗，能竞争性抑制表皮生长因子的结合。西妥昔单抗一般耐受性良好，但已有超敏输液反应的报道。俄克拉荷马大学的发病率目前尚不清楚，尽管坊间传闻很高。本研究的目的是确定重度HIRS的发生率，其次是确定西妥昔单抗引起输液超敏反应的危险因素。方法和结果：对俄克拉荷马大学健康科学中心2005年至2010年门诊接受西妥昔单抗治疗的所有患者进行了回顾性图表回顾。共有153名患者被纳入分析。严重超敏反应发生率为12.4%。男性患者严重输液过敏反应的发生率高于女性患者(20.6%对5%，p=0.0036)。与从不吸烟者或曾经吸烟者相比，目前吸烟者严重超敏输液反应的发生率增加了23.6%，p=0.0012。与其他类型的肿瘤相比，宫颈癌发生严重超敏反应的风险显著降低(5.3%vs.16.7%，p=0.0387)。多因素分析确定与重度HIRS相关的危险因素为：男性，RR=3.9，p=0.01，当前吸烟者，RR=3.98，p=0.0048。结论：与全国平均水平相比，俄克拉荷马大学的患者严重超敏输液反应的发生率更高。在我们的研究中，男性患者和当前吸烟者发生严重超敏输液反应的风险增加。有必要进行进一步的调查。
INTRODUCTION: Cetuximab is a chimeric mouse-human (30:70) IgG1 monoclonal antibody that competitively inhibits the binding of epidermal growth factor. Cetuximab is generally well tolerated; however, hypersensitivity infusion reactions have been reported. The incidence at the University of Oklahoma was currently unknown, though anecdotally high. The purpose of this study was to determine the incidence of severe HIRs and secondarily to determine risk factors for cetuximab-induced hypersensitivity infusion reactions.METHODS AND RESULTS: A retrospective chart review was conducted and included all patients that received cetuximab from 2005 to 2010 at the outpatient clinics of the Oklahoma University Health Sciences Center. A total of 153 patients were included in the analysis. The overall incidence proportion of severe hypersensitivity infusion reactions was 12.4%. Male patients had an increased incidence of severe hypersensitivity infusion reactions compared to female patients (20.6% vs. 5%, p=0.0036). Current smokers had an increased incidence of severe hypersensitivity infusion reactions of 23.6% when compared to never smokers or former smokers, p=0.0012. Cervical cancer had a significantly decreased risk of severe hypersensitivity infusion reactions when compared to other tumor types (5.3% vs. 16.7%, p=0.0387). Multivariate analysis identified risk factors associated with severe HIRs to be: male gender, RR=3.9, p=0.01 and current smokers, RR=3.98, p=0.0048.CONCLUSION: Patients at the University of Oklahoma had an increased incidence of severe hypersensitivity infusion reactions when compared to the national average. Male patients and current smokers were found to be at increased risk for severe hypersensitivity infusion reactions in our study. Further investigation is warranted.