Pharmacotherapy for the management of cancer regimen-related oral mucositis

ABSTRACT

Introduction: Oral mucositis is a frequent and devastating toxicity secondary to cancer treatment, which may affect 20–40% of patients receiving conventional chemotherapy and 60–85% of patients undergoing hematopoietic stem cell transplantation. The pathobiology of mucositis includes a complex cascade of biologic events in which pro-inflammatory cytokines, ROS, second messengers, and the oral microbiome contribute to tissue damage of the oral mucosa. Management strategies to oral mucositis secondary to chemotherapy include preventative measures and therapeutic approaches.

Area covered: A literature search of published animal and clinical studies was perform to review the epidemiology, pathophysiology and treatment options for cancer regimen-induced mucositis. We also discuss new data coming from recent pertinent clinical trials.

Expert opinion: Mucositis is one of the most common debilitating toxicities secondary to cancer treatment and can adversely affect patients’ quality of life. Epidemiological data for mucositis are often under-reported. Research efforts have shown that genetics plays a major role in the development of this toxicity. Although few therapeutic agents are available, several promising drugs are under investigations.

KEYWORDS:

• Oral mucositis
• chemotherapy
• toxicity

Article highlights

• Mucositis is a common debilitating toxicity that develops in approximately 20–40% of patients receiving conventional chemotherapy and in 60–85% of patients undergoing HSCT.

• The pathobiology of mucositis includes a five stage complex cascade of biologic events.

• Few therapeutic agents for oral mucositis are available and several promising drugs are under investigations.

• New genome-wide risk prediction–tools will identify genetically predisposed individuals at risk of developing oral mucositis in order to personalize treatment for these patients

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded