Low Eosinophil Percentages as a New Predictive Marker for Infusion Reactions Due to Trastuzumab

Takahashi, Masaya; Takahashi, Katsuyuki; Matsumoto, Saya; Takashima, Tsutomu; Asano, Yuka; Morisaki, Tamami; Kashiwagi, Shinichiro; Noda, Shinichi; Onoda, Naoyoshi; Ohira, Masaichi; Nagayama, Katsuya

doi:10.21873/anticanres.14401

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…Therefore, the increased dose of rituximab may help explain the high incidence of IRRs. In previous studies on other monoclonal antibodies, including trastuzumab 15,17) and ocrelizumab, 18) high actual BMI has been reported to be a predictive marker associated with IRRs.…”

Section: Discussionmentioning

confidence: 92%

Analysis of Risk Factors for Infusion-Related Reactions Following Rituximab Administration in Patients with Desensitization before Renal Transplantation

Nishiura,

Takahashi,

Iwai

et al. 2023

Biological & Pharmaceutical Bulletin

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Infusion-related reactions (IRRs) are the major side effects of rituximab administration. Although several studies have reported predictive markers for IRRs in patients with malignancies, there are no such reports for patients without malignancies. Accordingly, we aimed to clarify the predictive markers for rituximabinduced IRRs in renal transplant recipients. This retrospective study included 116 inpatients aged ≥18 years who received an initial dose of 150 mg/m 2 of rituximab for desensitization before renal transplantation with loxoprofen and diphenhydramine before rituximab infusion between June 2007 and February 2022. Overall, 45 patients were evaluated and 71 patients were excluded in this study. IRRs were observed in 12 (26.7%) patients. The proportion of men in the IRRs group was significantly higher than that in the non-IRRs group (p 0.023). Additionally, body weight, body surface area (BSA), and body mass index (BMI) were significantly higher in the IRRs group than in the non-IRRs group (body weight, p 0.0058; BSA, p 0.0051; BMI, p 0.017). Their cutoff values for predicting rituximab-induced IRRs, based on the receiver-operating characteristic curve, were 74.850 kg, 1.910 m 2 and 24.164 kg/m 2 , respectively. In conclusion, the male sex, high actual body weight, BSA, and BMI may be new predictive markers for rituximab-induced IRRs in renal transplant recipients. Therefore, clinicians should carefully monitor patients who receive rituximab before renal transplantation and present with the predictive markers.

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Section: Discussionmentioning

confidence: 92%

Analysis of Risk Factors for Infusion-Related Reactions Following Rituximab Administration in Patients with Desensitization before Renal Transplantation

Nishiura,

Takahashi,

Iwai

et al. 2023

Biological & Pharmaceutical Bulletin

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“…In a recently published retrospective study, no association between survival and eosinophil count was detected in 601 breast cancer patients of all subtypes [ 74 ]. Takahashi et al showed an association between infusion reactions to trastuzumab and a low eosinophil count, while another study showed an association between a high level of immunoglobulin E and a lower risk of cardiotoxicity in patients treated with anthracyclines and trastuzumab, suggesting that eosinophils are also involved in tolerance to anticancer treatments [ 75 , 76 ].…”

Section: Eosinophils and Breast Cancermentioning

confidence: 99%

Immunity and Breast Cancer: Focus on Eosinophils

Poncin¹,

Onesti

Josse

et al. 2021

Biomedicines

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The role of eosinophils, a cell type involved in the immune response to parasitic infections and allergies, has been investigated in different cancer types, in both tumor tissue and at the circulating level. Most studies showed a role mainly in conjunction with immunotherapy in melanomas and lung tumors, while few data are available in breast cancer. In this review, we summarize literature data on breast cancer, showing a prognostic role of circulating eosinophil counts as well as of the presence of tumor tissue infiltration by eosinophils. In particular, some studies showed an association between a higher circulating eosinophil count and a good prognosis, as well as an association with response to neoadjuvant chemotherapy in hormone receptor-negative/HER2-positive and in triple negative breast cancer. Several mechanistic studies have also been conducted in in vivo models, but the exact mechanism by which eosinophils act in the presence of breast cancer is still unknown. Further studies on this subject are desirable, in order to understand their role at the cellular level, identify related biomarkers and/or possibly search for new therapeutic targets.

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“…In a previous study, low eosinophil levels were associated with trastuzumab-induced IRR in breast cancer patients. 53 High eosinophil counts were a risk factor for cetuximab-induced IRR in patients with squamous cell carcinoma of the head and neck. 42 Therefore, the influence of blood eosinophils on the development of IRRs caused by monoclonal antibody preparations shows conflicting results.…”

Section: Discussionmentioning

confidence: 93%

Preventive effects of dexamethasone premedication on the development of infusion-related reactions in breast cancer patients receiving trastuzumab

Goto¹,

Hata²,

Nishihara³

et al. 2022

Preprint

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Aim To clarify the incidence and risk factors of infusion-related reactions (IRRs) to trastuzumab in breast cancer patients and verify the preventive effects of glucocorticoids. Methods The electronic medical record data at the time of trastuzumab administration were retrospectively reviewed. The following exclusion criteria were applied to 229 breast cancer patients who received trastuzumab at Osaka Medical and Pharmaceutical University Hospital during the 4-year study period: missing information on human epidermal growth factor receptor type 2 (HER2) status (n=1); missing information on eosinophils (n=11); or use of treatments other than trastuzumab (n=41). Results The 176 patients included in the study received 2,320 infusions. Fifty-eight patients (33.0%) experienced IRRs, and IRRs occurred in 80 (3.4%) of the 2,320 infusions. Owing to the hierarchical structure of the data, the independence of the observed values was evaluated using the intraclass correlation coefficient. Multivariate multilevel logistic regression analysis showed that premedication with dexamethasone was effective in lowering IRR risk with trastuzumab (mg; per unit; odds ratio, OR=0.62; 95% confidence interval, 95% CI, 0.44‒0.86; p=0.005). Preoperative status (OR=34.7; 95% CI, 5.0–242.0; p<0.001) and high doses of trastuzumab (mg/kg; per unit; OR=59.6; 95% CI, 19.7–180.0; p<0.001) were independent risk factors for IRRs. Conclusion The results of this study suggest that premedication with dexamethasone has a protective effect against IRRs caused by trastuzumab in breast cancer treatment. Future studies are needed to determine the optimal dosing of dexamethasone to prevent IRRs and the impact of dexamethasone on the efficacy of trastuzumab treatment.

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Low Eosinophil Percentages as a New Predictive Marker for Infusion Reactions Due to Trastuzumab

Cited by 4 publications

References 15 publications

Analysis of Risk Factors for Infusion-Related Reactions Following Rituximab Administration in Patients with Desensitization before Renal Transplantation

Analysis of Risk Factors for Infusion-Related Reactions Following Rituximab Administration in Patients with Desensitization before Renal Transplantation

Immunity and Breast Cancer: Focus on Eosinophils

Preventive effects of dexamethasone premedication on the development of infusion-related reactions in breast cancer patients receiving trastuzumab

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