ONS Connect - September 2008 - (Page 18)

fivEmiNuTEiNSErviCE AS Seen in tHe CliniCal Journal of onCology nursing Manage Infusion Reactions From Cetuximab [By elisa Becze, BA, ONS Staff Writer] atients receiving monoclonal antibodies such as cetuximab may be at risk for infusion reactions. Reactions related to the drugs are usually a result of cytokine-release syndrome, which has many signs and symptoms similar to that of a hypersensitivity reaction; it is caused by mast cells releasing cytokines and other effects of the immune system. In her article in the June 2008 issue of the Clinical Journal of Oncology Nursing, Gail Wilkes (2008) outlined the information that nurses administering monoclonal antibodies need to know about infusion reactions: risk factors, symptoms, and management options. infusion and hypersensitivity reactions Patients are usually at highest risk for a true hypersensitivity reaction on their second exposure to a drug. However, with cetuximab, 90% of infusion reactions occur during the first infusion. On initial exposure, a patient develops immunoglobulin E (IgE) antibodies to the drug, which coat the patient’s mast cells. On the second exposure to the drug, the IgE antibodies cause the mast cells to rupture, releasing histamine, prostaglandins, leukotrienes, and cytokines into the bloodstream, resulting in the reaction. Signs and symptoms of hypersensitivity reactions range from mild to moderate (e.g., fever, urticaria, transient flushing, rash, dyspnea) to severe (e.g., symptomatic bronchospasm P Key Definitions Cetuximab: a monoclonal antibody that blocks the activation of epidermal growth factor receptor in tumor cells; it is used to treat colorectal cancer and some head and neck cancers. Infusion reaction: describes a range of patient responses to the infusion of certain chemotherapy or biotherapy agents, from localized allergic responses to sudden death from cytokine release Monoclonal antibodies: a class of biologic therapy (biotherapy) that uses manufactured antibodies to directly kill as well as to stimulate an immune response to cancer cells; they also may bring chemotherapy or radioisotopes to the cancer cell to kill it. Monoclonal antibodies are currently the most widely used form of cancer biotherapy. Five-Minute In-Service is a monthly feature that offers readers a concise recap of a full-length article published in the Clinical Journal of Oncology Nursing (CJON) or Oncology Nursing Forum. This edition summarizes “Managing Drug Infusion Reactions: Focus on Cetuximab Monoclonal Antibody Therapy” by Gail Wilkes, RN, MS, AOCN®, ANP, which was featured in the Supportive Care column in the June 2008 issue of CJON. Questions regarding the information presented in this Five-Minute In-Service should be directed to the CJON editor at CJONEditor@ons.org. Photocopying of this article for educational purposes and group discussion is permitted. 18 ONS CONNECT September 2008

Table of Contents Feed for the Digital Edition of ONS Connect - September 2008

ONS Connect - September 2008 Contents Editor's Note Just In Advances in Prostate Cancer Treatment A Year in the Life - Month Nine Web Connect Capitol Connection Manage Infusion Reactions From Cetuximab Notice Nursing Now Caregiver Care Oropharyngeal Cancer in Men Associated with HPV Working for You Calendar of Events Staying on Top

ONS Connect - September 2008

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