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
in 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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Food Hypersensitivity
/
Anaphylaxis
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Humans
Language:
En
Journal:
BMC Cancer
Journal subject:
NEOPLASIAS
Year:
2023
Document type:
Article
Affiliation country:
France
Country of publication:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM