The broadening scope of oral mucositis and oral ulcerative mucosal toxicities of anticancer therapies

Abstract

Oral mucositis (OM) is a common, highly symptomatic complication of cancer therapy that affects patients' function, quality of life, and ability to tolerate treatment. In certain patients with cancer, OM is associated with increased mortality. Research on the management of OM is ongoing. Oral mucosal toxicities are also reported in targeted and immune checkpoint inhibitor therapies. The objective of this article is to present current knowledge about the epidemiology, pathogenesis, assessment, risk prediction, and current and developing intervention strategies for OM and other ulcerative mucosal toxicities caused by both conventional and evolving forms of cancer therapy.

Precision medicine for risk prediction of oral complications of cancer therapy–The example of oral mucositis in patients receiving radiation therapy for cancers of the head and neck

“…While there seems little doubt that genomics plays a significant role in risk determination, three important considerations remain: (1) The impact of genes on risk is likely the consequence of collective and collaborative activity between and amongst genes so consequently, the risk impact represents the consequences of a collective effect of multiple genes. (2) There is an absence of large-scale prospective trials to confirm the predictive accuracy of proposed risk genes. (3) The global somatic and germ line gene expression impact and their relationship to each other is still lacking.…”

“…The newest version of the NCI-CTC does not require clinical assessment and relies symptoms and diet, whereas older CTC versions were dependent on clinical descriptors of ulcerations. Even more complicating are those studies, usually retrospective, in which OM severity is based on an interpretation of clinical notes [ 2 ].…”

“…Almost all patients treated with standard regimens of chemoradiation (CRT) for oral or oropharyngeal cancers develop some level of tissue damage in the form of oral mucositis (OM) [ 2 ]. The clinical presentation of OM ranges from mild erythema and atrophy to deep, confluent, irregular full-thickness ulcerations impacting the movable oral mucosa.…”

Protective Effects of Cannabidiol on Chemotherapy-Induced Oral Mucositis via the Nrf2/Keap1/ARE Signaling Pathways

“…Oral mucositis (OM) is one of the most common and serious complications under standard dose chemotherapy, radiotherapy, and pretreatment of hematopoietic stem cell transplantation [ 1 , 2 ] and refers to pathological changes in oral mucosa, including erythema, ulceration, and necrosis after oncotherapy [ 3 ]. For patients with head and neck tumors, the incidence of OM is almost 100% [ 1 , 4 , 5 ]. Pain, infection, and difficulty eating affect life quality and oncotherapy prognosis [ 6 ].…”

“…Pain, infection, and difficulty eating affect life quality and oncotherapy prognosis [ 6 ]. However, current treatments focused on symptom relief have insufficient effectiveness [ 1 ]. The FDA-approved drug for OM, recombinant human keratinocyte growth factor palifermin , is also limited by its high cost and circumscribed efficacy [ 7 ].…”