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Biologicals are crucial targeted therapeutic agents in oncological, immunological, and inflammatory diseases, and their use in clinical practice is broadening. In recent years, the spread of Personalized Precision Medicine has facilitated a proliferation of new treatment options, especially biologicals. Consequently, biologicals are now among the drugs that most frequently cause hypersensitivity reactions (HSRs). Patients can develop HSRs to these agents during the first‐lifetime exposure or after repeated exposure, and these HSRs can be potentially life‐threatening or limit therapeutic options. Despite the relatively high prevalence, the underlying mechanisms of these HSRs remain obscure, and the optimal management pathways are still a matter of discussion. In this Position Paper, the authors will provide evidence‐based recommendations for diagnosing and managing HSRs to biologicals. Additionally, the document defines unmet needs as an opportunity to shape future research. [ABSTRACT FROM AUTHOR]

Interleukin-6: A novel biomarker for monoclonal antibody and chemotherapy-associated hypersensitivity confirms a cytokine release syndrome phenotype-endotype association Keywords: IL-6; Rapid Drug Desensitization; Tryptase EN IL-6 Rapid Drug Desensitization Tryptase 1571 1573 3 05/17/21 20210501 NES 210501 To the Editor, Interleukin-6(IL-6) is a pleotropic cytokine postulated to underlie a unique clinical phenotype observed in certain breakthrough reactions (BTRs) occurring during rapid drug desensitization(RDD) to chemotherapy and biologic agents.1,2 IL-6 is an endogenous pyrogen and proinflammatory mediator that plays a role in both innate and adaptive immunity.3 Under typical physiologic conditions, levels are relatively low, ranging from 1 to 5 pg/mL.3 In this study, we aimed to further explore IL-6 as a possible biomarker for BTRs seen during RDD to conventional chemotherapeutic or biologic agents and determine the phenotypic constellation with which elevated levels may correlate. Neuromuscular complaints were also significantly higher in reactions associated with an elevated IL-6 level (IL6 > 17.5 pg/mL 65.5% vs IL6 < 17.5 pg/mL 11.1%;P = .0042) gl IL-6 levels were significantly increased during the reactions at 627.8 ± 1007.5 pg/mL. [Extracted from the article]