Galactose-ƒ¿-1,3-galactose (ƒ¿-gal)-specific IgE test is highly useful for predicting cetuximab-induced anaphylaxis

Background Cetuximab, a chimeric mouse-human IgG1 monoclonal antibody against the epidermal growth factor receptor, is approved for use in colorectal cancer and squamous-cell carcinoma of the head and neck. A high prevalence of hypersensitivity reactions to cetuximab has been reported in some areas of the United States. IgE antibodies against cetuximab were present in the patients with cetuximab hypersensitivity and the antibodies were specific for galactose-1,3-galactose (-gal) in cetuximab heavy-chain. We have also determined that patients with red meat allergy have IgE antibodies against ƒ¿-gal in Japan. In 2013, twelve patients with squamous-cell carcinoma of the head and neck were treated with cetuximab in Matsue Red Cross hospital, and found that four of twelve patients had anaphylactic shock during first infusion of cetuximab. None of them had allergic reaction to red meat before the treatment. In this study, we aimed to clarify whether the reaction was IgE-mediated or not.