Researchers backed by the National Institutes of Health have figured out why some patients develop anaphylactic reactions to cetuximab, an immune-based drug commonly used to treat head, neck, and colon cancers. By testing serum samples from 538 patients, the researchers found that those who rapidly developed anaphylaxis were more likely to have pre-existing IgE antibodies to a specific sugar molecule on cetuximab.
   Because patients in certain areas of the country are markedly more likely to develop anaphylaxis than patients in other areas, researchers now hope to determine what might explain the variable presence of IgE antibodies--possibly a regional difference in exposure to ticks, other parasites, or infectious organisms.
   The researchers concluded that, because of the widespread use of cetuximab, it may be useful to screen patients for IgE antibodies to cetuximab before starting therapy.
   A partially humanized mouse monoclonal antibody, cetuximab is produced by a single cell line and acts against a specific protein. It controls cancer growth by inhibiting a growth factor receptor on the cell surface. Severe anaphylactic responses have occurred with other monoclonal antibodies, but this is the first time researchers have explained the mechanism behind the reaction.

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