Safety of Ramucirumab Regimen Without H1-antihistamine Premedication in Patients With Solid Cancers

Abstract

Background/aim: To prevent infusion-related reactions (IRRs), H1-antihistamines (H₁AT) are recommended as a premedication for monoclonal antibodies, such as Ramucirumab (RAM), even though there are H₁AT-related side effects, such as drowsiness and dizziness. Here, we investigated the safety of H₁AT-free RAM regimens in patients with solid cancer.

Patients and methods: We retrospectively reviewed the patients with solid cancer receiving RAM without H₁AT at Osaka Medical College Hospital between 2015 and 2019.

Results: Among the 123 registered patients, 58 were identified as eligible. The total number of RAM infusions was 291, and the median number of RAM administration was 4 cycles (range=1-23 cycles). IRRs were not observed in any patient.

Conclusion: Although our data are preliminary and limited, H₁AT-free RAM regimens may be a treatment option for cancer patients having a significant risk of developing H₁AT-related side effects. Further studies are needed to confirm the safety of H₁AT-free RAM regimens.

Keywords: H1-antihistamines; Ramucirumab; infusion-related reactions; monoclonal antibodies.