D2.434 - AllergoOncology: Novel crusade for Basophil Activation Test

The “Granulocytes and mast cells: Understanding their roles in allergy and tumor immunity (GranulAO)” EAACI Task Force represents the combined translational and interdisciplinary knowledge of experts in the fields of Allergy and AllergoOncology. A particular focus has been applied to extracting the common features of granulocytes, including basophils, eosinophils, and neutrophils, along with mast cells, and their sometimes bivalent roles in allergy and cancer, and to bridging our understanding of these two disciplines. 

The GranulAO Task Force aims to initiate new and original avenues for this interdisciplinary research encompassing the experience in allergy and oncology. One important diagnostic tool with not yet fully exploited potential in both areas is the Basophil Activation Test (BAT).

This tool is increasingly becoming an established assay in a growing number of routine diagnostic laboratories in the field of allergy, to predict, diagnose, and monitor hypersensitivity reactions to different allergen sources and allergens. BAT is also an emerging promising diagnostic and management tool to assess hypersensitivity reactions to biologics and chemotherapy agents, monitor drug tolerance in desensitisation protocols in the clinic, and predict and address the safety of novel anti-cancer IgE-based therapeutics. BAT showed sensitivity of 73% with 100% specificity in diagnosis of reactions to platinum compounds, and for paclitaxel these were 53% sensitivity and 87% specificity. Specific IgE measurement and skin tests are not always available or informative, whereas BAT can be utilized. In addition, BAT may be informative to identify in vivo basophil activated status to evaluate immune responses and potential associations with disease outcomes in the context of allergy and cancer.

Capitalising on long-acquired expertise on the development of BAT for allergy diagnostics and pathomechanistic understanding, this test also has the potential of being a valuable tool in the field of AllergoOncology. Collating all reported evidence together, and despite the limitations of the test and remaining open questions, BAT should be implemented in monitoring allergic reactions to chemotherapeutics and biologicals and in efforts to further identify biomarkers allowing improved patient phenotyping, stratification for current therapies, and the development of new therapies for the oncology clinic.