Skip to main content
Top
Published in: Supportive Care in Cancer 1/2009

01-01-2009 | Original Article

Implications of IV monoclonal antibody infusion reaction for the patient, caregiver, and practice: results of a multicenter study

Authors: Lee S. Schwartzberg, Edward J. Stepanski, Mark S. Walker, Susan Mathias, Arthur C. Houts, Barry V. Fortner

Published in: Supportive Care in Cancer | Issue 1/2009

Login to get access

Abstract

Goals of work

Targeted monoclonal antibodies (MoAbs) have become a promising treatment option for patients with cancer. However, there is a risk of developing infusion reactions (IRs) with MoAbs. This study was conducted to evaluate the impact of IRs on staff time and costs among patients receiving an initial infusion of cetuximab (Erbitux®) and rituximab (Rituxan®).

Patients and methods

A prospective multicenter study involving time and motion and activity sampling methods was conducted among patients with cancer receiving their first outpatient infusion of cetuximab or rituximab. Patients were observed from initiation of MoAb infusion to the end of the clinic visit. IRs were classified as absent, mild/moderate, and severe/life threatening. Staff time and costs were estimated for preparation and administration of MoAb, other chemotherapy agents, and for management of IRs. Resource costs were compared across IR groups within each MoAb.

Main results

Among 161 patients enrolled, 32% of 71 patients on cetuximab and 39% of 90 patients on rituximab experienced IRs. Treatment of patients who experienced IRs required more staff time (31–80% more time) and resulted in higher human resource costs (increase of 17–65 US dollars) than patients who did not experience IRs.

Conclusions

IRs following cetuximab and rituximab administration are common and are associated with measurably increased costs of care. The frequency of IRs suggests the importance of identifying clinical guidelines for intervention and management.
Literature
2.
go back to reference Cersosimo RJ (2003) Monoclonal antibodies in the treatment of cancer, part 2. Am J Health Syst Pharm 60:1631–1641, quiz 42–43.PubMed Cersosimo RJ (2003) Monoclonal antibodies in the treatment of cancer, part 2. Am J Health Syst Pharm 60:1631–1641, quiz 42–43.PubMed
3.
go back to reference Cersosimo RJ (2003) Monoclonal antibodies in the treatment of cancer, part 1. Am J Health Syst Pharm 60:1531–1548.PubMed Cersosimo RJ (2003) Monoclonal antibodies in the treatment of cancer, part 1. Am J Health Syst Pharm 60:1531–1548.PubMed
5.
go back to reference Fortner BV, Tauer K, Zhu L, Okon TA, Moore K, Templeton D et al (2004) Medical visits for chemotherapy and chemotherapy-induced neutropenia: a survey of the impact on patient time and activities. BMC Cancer 4:22. doi:10.1186/1471-2407-4-22 PubMedCrossRef Fortner BV, Tauer K, Zhu L, Okon TA, Moore K, Templeton D et al (2004) Medical visits for chemotherapy and chemotherapy-induced neutropenia: a survey of the impact on patient time and activities. BMC Cancer 4:22. doi:10.​1186/​1471-2407-4-22 PubMedCrossRef
6.
go back to reference Genetech (2005). Drug label for rituxan, vol 2007. Genetech Genetech (2005). Drug label for rituxan, vol 2007. Genetech
7.
go back to reference Green SBAU, McCoy JF, Burns KP, Smith AC (1982) Accuracy of observational data with whole interval, partial interval, and momentary time-sampling recording techniques. J Behav Assess 4:103–118 doi:10.1007/BF01321385 CrossRef Green SBAU, McCoy JF, Burns KP, Smith AC (1982) Accuracy of observational data with whole interval, partial interval, and momentary time-sampling recording techniques. J Behav Assess 4:103–118 doi:10.​1007/​BF01321385 CrossRef
8.
go back to reference ImClone and Bristol-Myers Squibb (2005) ImClone and Bristol-Myers Squibb Erbitux drug label, vol 2007. ImClone and Bristol-Myers Squibb, Princeton, NJ ImClone and Bristol-Myers Squibb (2005) ImClone and Bristol-Myers Squibb Erbitux drug label, vol 2007. ImClone and Bristol-Myers Squibb, Princeton, NJ
9.
go back to reference Kohler G, Milstein C (2005) Continuous cultures of fused cells secreting antibody of predefined specificity. 1975. J Immunol 174:2453–2455.PubMed Kohler G, Milstein C (2005) Continuous cultures of fused cells secreting antibody of predefined specificity. 1975. J Immunol 174:2453–2455.PubMed
10.
go back to reference National Cancer Institute (2003) Common terminology criteria for adverse events v3.0 (ctc). National Cancer Institute, Oxford National Cancer Institute (2003) Common terminology criteria for adverse events v3.0 (ctc). National Cancer Institute, Oxford
13.
go back to reference Rajpal S, Venook AP (2006) Targeted therapy in colorectal cancer. Clin Adv Hematol Oncol 4:124–132.PubMed Rajpal S, Venook AP (2006) Targeted therapy in colorectal cancer. Clin Adv Hematol Oncol 4:124–132.PubMed
Metadata
Title
Implications of IV monoclonal antibody infusion reaction for the patient, caregiver, and practice: results of a multicenter study
Authors
Lee S. Schwartzberg
Edward J. Stepanski
Mark S. Walker
Susan Mathias
Arthur C. Houts
Barry V. Fortner
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 1/2009
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-008-0474-5

Other articles of this Issue 1/2009

Supportive Care in Cancer 1/2009 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine