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March 2016

Complete Remission of Squamous Cell Carcinoma After Treatment With Panitumumab in a Patient With Cetuximab-Induced Anaphylaxis

Author Affiliations
  • 1Dermatology Department, CHU de Bordeaux, University of Bordeaux, Bordeaux, France
  • 2Radiotherapy Department, CHU de Bordeaux, Hôpital Haut Lévêque, Bordeaux France
JAMA Dermatol. 2016;152(3):343-345. doi:10.1001/jamadermatol.2015.4134

A patient with locally advanced cutaneous squamous cell carcinoma (cSCC) who had had an anaphylactic reaction to an epidermal growth factor receptor (EGFR) inhibitor, cetuximab, responded to panitumumab.

An 89-year-old man presented with a locally advanced cSCC of the nose that was 35 mm in diameter. The exophytic, ulcerated, necrotic tumor invaded local cartilage, but there was no metastasis (T4N0M0) (Figure, A). The large size of the lesion and difficulty in repairing the defect after excision made surgery inappropriate. In addition, the patient’s other comorbidities precluded general anesthesia. He received radiation therapy at a dose of 40 Gy in 10 fractions. The tumor progressed immediately after irradiation with a voluminous infiltrated peripheral bulge. Skin biopsy confirmed the persistence of invasive cSCC. Owing to the patient’s age and medical history, the multidisciplinary team recommended systemic palliative treatment with an EGFR inhibitor (cetuximab, 400 mg/m2) beginning 3 months after cessation of the radiation therapy. The first infusion immediately led to an anaphylactic reaction. Anti-galactose-α-1,3-galactose (α-gal) antibodies were detected. The cetuximab treatment was stopped.