Table 1.
Information on hypersensitivity reactions to marketed monoclonal antibodies.
| Brand Name (Manufacturer) | INN, Isotype (Target Antigen) | Indication | Incidence | Symptoms | References |
|---|---|---|---|---|---|
| Anticancer use | |||||
| Avastin (Genentech, San Francisco, CA, USA; Roche, Basel, Switzerland) | bevacizumab, humanized IgG1 (VEGF-A) | combination chemotherapy of metastatic colon, lung, and kidney cancer, and glioblastoma | <3%, severe: 0.2% | chest pain, diaphoresis, headache, hypertension, neurologic signs and symptoms, oxygen desaturation, rigors, wheezing | [2,4] |
| Campath (Genzyme, Cambridge, MA, USA) | alemtuzumab–IH, humanized IgG1κ (CD52 on T and B cells) | B cell chronic lymphocytic leukemia (B-CLL) | 4–7% | bronchospasm, chills, dyspnea, emesis, fever, hypotension, nausea, pyrexia, rash, rigors, tachycardia, urticaria | [2,5] |
| Erbitux (Bristol-Myers Squibb, New York, NY, USA; Eli Lilly, Indianapolis, IN, USA) | cetuximab, chimeric IgG1κ (EGFR) | metastatic colorectal cancer, head and neck cancer, squamous cell carcinomas | <3%, fatal < 0.1% | anaphylaxis, angioedema, bronchospasm, cardiac arrest, chills, dizziness, dyspnea, fever, hoarseness, hypotension, pruritus, rash, rigor, stridor, urticaria, wheezing | [1,2,3] |
| Herceptin (Genentech, San Francisco, CA, USA) | trastuzumab, humanized IgG1κ (EGFR receptor 2, HER2/neu/erbB2) | metastatic breast and gastric cancer | <1% | asthenia, bronchospasm, chills, death within hours, dizziness, dyspnea, further pulmonary complications, headache, hypotension, hypoxia, nausea, pain, rash, severe hypotension, vomiting | [1,2,3] |
| Rituxan (Genentech, San Francisco, CA, USA) | rituximab, chimeric IgG1κ (CD20 on B cells) | B cell leukemias, rheumatoid arthritis and non-Hodgkin’s B-cell lymphoma | >80%, severe: <10% | ARDS, bronchospasm, cardiogenic shock, flushing, hypotension, hypoxia, itching, myocardial infarction, pain (at the site of the tumor), pulmonary infiltrates, runny nose, swelling of the tongue or throat, ventricular fibrillation, vomiting | [1,2,3,6] |
| Anti-inflammatory use | |||||
| Remicade (Janssen Biotech. Inc., Horsham, PA, USA) | infliximab, chimeric IgG1κ (TNF alpha) | Crohn’s disease, rheumatoid arthritis, spondylitis ankylopoetica, arthritis psoriatica, ulcerative colitis | 18% | bronchospasm, laryngeal edema, pharyngeal edema, dyspnea, hypotension, urticaria, serum sickness-like reactions | [3] |
| Xolair (Genentech, San Francisco, CA, USA) | omalizumab, humanized IgG4 (IgE) | atopia, asthma | 39%, Severe: 0.2% | anaphylaxis, bronchospasm, hypotension, syncope, urticaria, and/or angioedema of the throat or tongue, delayed anaphylaxis (with onset two to 24 h or even longer) beyond one year after beginning regularly administered treatment | [1] |
INN: international nonproprietary names; ARDS: acute respiratory distress syndrome.