Jean Grem, MD

Cetuximab (Erbitux), a chimeric antiepidermal growth factor receptor monoclonal antibody currently used to treat metastatic colorectal cancer, is in clinical development for several other solid tumors. Although cutaneous manifestations are the most common toxicities associated with cetuximab, they are rarely life-threatening. Cetuximab-related infusion reactions are less common, but they may become severe and cause fatal outcomes if not managed appropriately. Little about the specific etiology of these events is known; however, an overview of infusion reactions observed with other compounds may shed some light and help characterize cetuximab-related reactions. For physicians administering cetuximab, familiarity with acute reaction treatment protocols and preparedness to identify and manage symptoms promptly and effectively are most important to minimize potential risks.

Gowda and colleagues reviewed169 consecutive patients withesophageal or colorectal cancerwho received oxaliplatin-basedtherapy over a 2.5-year period to identifythe incidence of hypersensitivityreactions. Thirty-two patients (19%) experiencedhypersensitivity; some patientsexperienced more than onesymptom, including skin rash (13%),fever (3%), respiratory symptoms (3%),lacrimation/blurring of vision (1%), andlaryngeal/glossal edema (0.6%).