How would you approach first-line treatment for a patient with metastatic colon cancer who develops an anaphylactic reaction to cetuximab with FOLFOX/cetuximab/encorafenib?

In the guidelines, the fully humanized version of panitumumab can be used interchangeably where cetuximab is indicated for patients with colorectal cancer.

The anaphylactic reactions are not uncommon, going back to the homology with the tick bite story.

Chung et al., PMID 18337601

I have encountered pushback from some payers arguing that the study was with cetuximab. However, the fact that this patient had an anaphylactic reaction, there shouldn’t be issues with “peer to peer” and in getting the dr...