Tanz R, Meillan N, Libert N, Magne N, Vedrine L, Chargari C
Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, 74 Bd de Port-Royal, 75005, Paris, France,
Invest New Drugs. 2014 Jun;32(3):573-4. doi: 10.1007/s10637-014-0085-6. Epub 2014 Mar 29.
Trastuzumab is a standard treatment in breast cancer overexpressing Her2 oncogene. However, its administration carries the risk of severe immune adverse events which often lead to the discontinuation of trastuzumab. There is no clear guideline on how patients experiencing trastuzumab-related reaction should be rechallenged with the monoclonal antibody. Here, we present two case reports of patients who have presented severe anaphylactic reactions during trastuzumab infusion. Both of them have been successfully rechallenged in intensive care units with premedication, lower rate of infusion and vitals monitoring. Thereafter, trastuzumab could be continued without any serious adverse reaction. Given the positive impact of trastuzumab on patients' survival, treatment rechallenge should be carefully considered in patients who presented anaphylactic reactions.
曲妥珠单抗是治疗过表达Her2癌基因的乳腺癌的标准疗法。然而，其应用存在严重免疫不良事件的风险，这常常导致曲妥珠单抗治疗中断。对于经历曲妥珠单抗相关反应的患者，如何再次使用这种单克隆抗体尚无明确的指导原则。在此，我们报告两例在输注曲妥珠单抗期间出现严重过敏反应的患者。他们两人在重症监护病房通过预处理、降低输注速度和生命体征监测均成功再次接受了治疗。此后，曲妥珠单抗可以继续使用且未出现任何严重不良反应。鉴于曲妥珠单抗对患者生存的积极影响，对于出现过敏反应的患者应谨慎考虑再次进行治疗。
