Oral Manifestations in Melanoma Patients Treated with Target or Immunomodulatory Therapies

Dika, Emi; Lambertini, Martina; Gouveia, Bruna Melhoranse; Mussi, Martina; Marcelli, Emanuela; Campione, Elena; Gurioli, Carlotta; Melotti, Barbara; Alessandrini, Aurora; Ribero, Simone

doi:10.3390/jcm10061283

Cited by 10 publications

(5 citation statements)

References 50 publications

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“…In addition, the symptom profile for oral irAEs and non-oral irAEs falls on a spectrum and may also depend on cancer type. 34 …”

Section: Discussionmentioning

confidence: 99%

Comparisons of Non-Oral Immune-Related Adverse Events Among Patients With Cancer With Different Oral Toxicity Profiles

Xu,

Wen,

Haddad

et al. 2023

The Oncologist

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Objectives Immune-related adverse events (irAEs) are common. Oral irAEs tend to cluster in patients who experience concurrent toxicities. We aimed to characterize the frequency and trajectory of nonoral irAEs in patients who developed oral irAEs, assess their relationship with nonoral irAEs, and compare those characteristics with patients without oral irAEs. Methods A retrospective chart review was conducted to identify patients who started ICIT between December 11, 2011, and September 15, 2019 (n = 4683) in the Mass General Brigham Registered Patient Data Registry. Demographic information, cancer diagnosis, ICIT regimen, treatment duration, and time and number of infusions to irAE onset were recorded. Nonoral irAEs were categorized into 13 groups. Patients with melanoma, pulmonary cancer, or head and neck cancer who had oral irAEs were then matched with those without oral irAEs to compare the prevalence of concomitant nonoral irAEs. Results Three hundred and fourteen patients with oral irAEs with a mean age of 65.9 ± 12.6 years (43.3% females) were included. Patients with multiple oral irAEs were more likely to have nonoral irAEs (OR: 2.7, 95% CI, 1.3-3.5), including cutaneous (OR: 1.7, 95% CI, 1.1-3.0), rheumatological (OR: 2.2, 95% CI, 1.1-4.2), thyroid (OR: 2.4, 95% CI, 1.2-4.9), and neurological irAEs (OR: 2.5, 95% CI, 1.0-6.3). Compared to matched patients with non-oral irAEs, patients with oral irAEs were more likely to have cutaneous (OR: 1.7, 95% CI, 1.0-2.8) and thyroid (OR: 2.86, 95% CI, 1.1-7.5) irAEs. The development of oral and nonoral irAEs is often coincidental. Conclusion Patients who have nonoral irAEs should be monitored for development of oral irAEs for prompt management.

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“…In addition, the symptom profile for oral irAEs and non-oral irAEs falls on a spectrum and may also depend on cancer type. 34 …”

Section: Discussionmentioning

confidence: 99%

Comparisons of Non-Oral Immune-Related Adverse Events Among Patients With Cancer With Different Oral Toxicity Profiles

Xu,

Wen,

Haddad

et al. 2023

The Oncologist

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“…Among the adverse effects of these drugs are oral adverse events. In this regard, the study by Dika et al evaluated these effects in patients affected by melanoma under treatment with BRAFi/MEKi and tyrosine kinase inhibitors and in patients treated with CTLA and PD1 inhibitors [ 67 ].…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, in the second group, the adverse effects are lichenoid reactions with possible risk of neoplastic evolution [ 75 , 76 ], bullous pemphigoid and erythema multiforme [ 67 ] and xerostomia with subsequent dysgeusia.…”

Section: Resultsmentioning

confidence: 99%

Oral Adverse Events Associated with BRAF and MEK Inhibitors in Melanoma Treatment: A Narrative Literature Review

Basilicata,

Terrano,

D'Aurelio

et al. 2024

Healthcare

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Background: Melanoma cancer represents the most lethal type of skin cancer originating from the malignant transformation of melanocyte cells. Almost 50% of melanomas show the activation of BRAF mutations. The identification and characterization of BRAF mutations led to the development of specific drugs that radically changed the therapeutic approach to melanoma. Methods: We conducted a narrative review of the literature according to a written protocol before conducting the study. This article is based on previously conducted studies. We identified articles by searching electronic databases (Medline, Google Scholar and PubMed). We used a combination of “melanoma”, “Braf-Mek inhibitors”, “ targeted therapy” and “oral side effects”. Results: Eighteen studies were reported in this article showing the relationship between the use of targeted therapy in melanoma cancer and the development of oral side effects, such as mucositis, hyperkeratosis and cellular proliferation. Conclusion: Targeted therapy plays an important role in the treatment of melanoma cancer, showing a notable increase in response rate, prolonged progression-free survival and overall survival in BRAF-mutated melanoma patients. Oral side effects represent a common finding over the course of treatment. However, these adverse effects can be easily managed in a multidisciplinary approach involving collaboration between medical oncologists and dental doctors.

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“…Likewise, oral mucosal toxicities have been described with the use of tyrosine kinase inhibitors (TKIs) and vascular endothelial growth factor (VEGF) inhibitors [ 4 ]. Another review also highlighted a case of glossitis in a patient who received just one cycle of nivolumab [ 5 ]. Preventative prophylactic strategies in reducing the incidence of oral mucositis in patients receiving chemotherapy and radiation have been recently described in the literature, and some institutions have even adopted them as the standard of care in preventing this adverse effect.…”

Section: Discussionmentioning

confidence: 99%

Pembrolizumab-Induced Immune-Mediated Glossitis

Alias¹,

Hall²,

Kulkarni³

et al. 2022

Cureus

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Pembrolizumab (Keytruda), an anti-PD-1 antibody used in the treatment of several different malignancies has been identified to cause adverse effects pertaining to multiple body systems which include respiratory, gastrointestinal, dermatologic, and endocrine manifestations known as immune-related adverse events (IRAEs). Skin manifestations have been most described in current literature highlighting the most common adverse effects of this agent. However, adverse outcomes involving the oral mucosa have been rarely identified in the PD-1 and PD-L1 inhibitor classes of immunotherapeutic agents. We present a case of a 71-year-old male who was treated with a chemotherapeutic regimen including pembrolizumab for newly diagnosed squamous cell carcinoma of the lung, who later developed ulcerations on his tongue that were consistent with glossitis. Upon determining that this adverse effect may be immune-related, the patient was treated with oral prednisone 40 mg with a 10 mg taper each subsequent week, which resulted in significant improvement in the patient’s symptoms following one month of treatment.

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Oral Manifestations in Melanoma Patients Treated with Target or Immunomodulatory Therapies

Cited by 10 publications

References 50 publications

Comparisons of Non-Oral Immune-Related Adverse Events Among Patients With Cancer With Different Oral Toxicity Profiles

Comparisons of Non-Oral Immune-Related Adverse Events Among Patients With Cancer With Different Oral Toxicity Profiles

Oral Adverse Events Associated with BRAF and MEK Inhibitors in Melanoma Treatment: A Narrative Literature Review

Pembrolizumab-Induced Immune-Mediated Glossitis

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