Validation of an anti-α-Gal IgE fluoroenzyme-immunoassay for the screening of patients at risk of severe anaphylaxis to cetuximab.
BMC Cancer
; 23(1): 32, 2023 Jan 09.
Article
em En
| MEDLINE
| ID: mdl-36624467
ABSTRACT
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.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Hipersensibilidade Alimentar
/
Anafilaxia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Humans
Idioma:
En
Revista:
BMC Cancer
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
França