Retrospective analysis of premedication, glucocorticosteroids, and H 1 -antihistamines for preventing infusion reactions associated with cetuximab treatment of patients with head and neck cancer

• Published in: Journal of international medical research 2017-08, Vol.45 (4), p.1378-1385
• Main Authors: Ikegawa, Kiwako, Suzuki, Shinya, Nomura, Hisanaga, Enokida, Tomohiro, Yamazaki, Tomoko, Okano, Susumu, Endo, Kazushi, Saito, Shinichiro, Yamaguchi, Masakazu, Tahara, Makoto
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Agents, Immunological - administration & dosage; Antineoplastic Agents, Immunological - adverse effects; Cetuximab - administration & dosage; Cetuximab - adverse effects; Chlorpheniramine - administration & dosage; Dexamethasone - administration & dosage; Female; Head and Neck Neoplasms - drug therapy; Histamine H1 Antagonists - administration & dosage; Humans; Hypersensitivity - prevention & control; Incidence; Infusions, Intravenous; Male; Middle Aged; Premedication; Retrospective Studies; Young Adult
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060517713531

Objectives We evaluated infusion-related reactions associated with cetuximab combination chemotherapy comprising an H1-receptor antagonist plus dexamethasone as anti-allergy premedications for patients with head and neck cancer. Methods We retrospectively evaluated 248 patients who received a cetuximab combination regimen between December 2012 and August 2015. All patients received 5 mg intravenous dichlorpheniramine (H1-receptor antagonist), and dexamethasone (DEX) was adjusted from 6.6 mg to 13.2 mg according to the emetogenic risk. Results We identified 248 subjects, including 13 (5.2%) with infusion-related reactions (grade 1 in five [2.0%], grade 2 in seven [2.8%], and grade 4 in one [0.4%]). The incidence of these reactions in cetuximab combination regimens, each employing an H1-receptor antagonist, using a higher dose of dexamethasone (13.2 mg) was not significantly lower compared with those using 6.6 mg DEX (2.4% vs 8.3%, respectively; p = 0.43). Twelve patients experienced infusion-related reactions associated with the first cetuximab administration, and one reaction occurred after the third administration. Conclusions The incidence of infusion-related reactions was lower compared with those of previous studies. Dexamethasone combined with an H1-receptor antagonist was useful for preventing allergic responses. The incidence of infusion-related reactions was not lower with 13.2 mg dexamethasone, and 6.6 mg DEX prevented infusion-related reactions.