Validation of an anti-α-Gal IgE fluoroenzyme-immunoassay for the screening of patients at risk of severe anaphylaxis to cetuximab, BMC Cancer
Por um escritor misterioso
Last updated 24 setembro 2024
Background The link between immediate hypersensitivity reactions (HSR) following the first cetuximab infusion and the IgE sensitization against anti-galactose-α-1,3-galactose (α-Gal) is now well-established. An automated Fluoroenzyme-Immunoassay (FEIA) is available and may facilitate the screening of patients with anti-α-Gal IgE before treatment. Methods This study aimed to evaluate its performances as compared to a previously validated anti-cetuximab IgE ELISA, using 185 samples from two previously studied cohorts. Results Despite 21.1% of discrepancies between the two techniques, FEIA discriminated better positive patients and similarly negative ones with a ≥ 0.525 kUA/L threshold. Sensitivity was 87.5% for both tests, specificity was better for FEIA (96.3% vs ELISA: 82.1%). FEIA had a higher positive likelihood ratio (23.9 vs ELISA: 4.89) and a similar negative likelihood ratio (0.13 vs ELISA: 0.15). In our population, the risk of severe HSR following a positive test was higher with FEIA (56.7% vs ELISA: 19.6%) and similar following a negative test (0.7% vs ELISA: 0.8%). Conclusion Although the predictive value of the IgE screening before cetuximab infusion remains discussed, this automated commercial test can identify high-risk patients and is suitable for routine use in laboratories. It could help avoiding cetuximab-induced HSR by a systematic anti-α-Gal IgE screening before treatment.
The role of IgE specific for galactose-α-1,3-galactose in predicting cetuximab induced hypersensitivity reaction: a systematic review and a diagnostic meta-analysis
Full article: Current and Future Strategies for the Diagnosis and Treatment of the Alpha-Gal Syndrome (AGS)
Frontiers The History of Carbohydrates in Type I Allergy
Anti-cetuximab IgE ELISA for identification of patients at a high risk of cetuximab-induced anaphylaxis. - Abstract - Europe PMC
IgE and mast cells in allergic disease
Risk of bias and applicability concerns summary.
Forest plot and SROC curve. Download Scientific Diagram
Prevalence of anti-cetuximab IgE. IgE levels were measured in serum
Hypersensitivity reactions to biologics (part I): allergy as an important differential diagnosis in complex immune-derived adverse events*
Anaphylactic Reactions to Oligosaccharides in Red Meat: a Syndrome in Evolution, Clinical and Molecular Allergy
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