Figure 4
From: Anaphylactic Reactions to Oligosaccharides in Red Meat: a Syndrome in Evolution
The possible mechanism behind cetuximab induced allergies. Cetuximab is a recombinant chimeric epidermal growth factor monoclonal antibody approved for treatment of metastatic colorectal and head and neck cancer [51, 59–61]. Infusion reactions with cetuximab are linked to the presence of IgE antibodies directed against the alpha-gal component of the Fab fragment of cetuximab heavy chain [51, 85]. Each cetuximab molecule contains two alpha-gal epitopes that can cross-link the high affinity receptor for IgE (FcεRI) on mast cells [51] leading to mast cell activation and release of hypersensitivity mediators [57].