Measuring tools for gastrointestinal toxicity
1Centre for Paediatric and Adolescent Gastroenterology, Women's and Children's Hospital, Children Youth and Women's Health Service, Adelaide, South Australia, Australia. ross.butler@adelaide.edu.au
Purpose Of Review:
The present review is timely owing to the previous paucity of biomarkers, particularly functional noninvasive tests, to evaluate the extent and severity of gastrointestinal toxicity in both animal models of chemotherapy and in cancer patients undergoing chemotherapy.
Recent Findings:
The most recent findings using noninvasive functional biomarkers now allow longitudinal monitoring of the time course of damage and repair that occurs in the gastrointestinal tract following radiotherapy and chemotherapy. This monitoring has in turn enabled collection of objective evidence for efficacy of new antimucositis agents using animal models and, more importantly, for use in future randomized, double-blind, placebo-controlled clinical trials.
Summary:
In the past 12 months the C sucrose breath test has been applied to a series of animal models of chemotherapeutic damage, showing rapid monitoring of the efficacy of particular bioactive molecules is now possible at different stages of the damage and repair cycle. This biomarker has also been applied to childhood cancer studies of mucositis and now needs to be used in adult cancers for eventual adoption in routine clinical management of mucositis. An exciting possibility would be extension of the biomarker use to predict damage in other regions of the gastrointestinal tract, including oral mucosa.
Insights
Noninvasive functional biomarkers, like the C sucrose breath test, now enable monitoring of gastrointestinal damage and repair from chemotherapy. This aids in evaluating new treatments for mucositis in cancer patients.
Area of Science:
- Oncology
- Gastroenterology
- Biomarker Development
Background:
- Limited noninvasive biomarkers previously existed for assessing chemotherapy-induced gastrointestinal toxicity.
- Evaluating the extent and severity of gastrointestinal damage in animal models and cancer patients was challenging.
Purpose of the Study:
- To review the advancements in noninvasive functional biomarkers for gastrointestinal toxicity.
- To highlight the utility of these biomarkers in monitoring damage and repair during cancer therapy.
Main Methods:
- Review of recent findings on noninvasive functional biomarkers.
- Application of the C sucrose breath test in animal models of chemotherapeutic damage.
- Analysis of studies involving mucositis in childhood cancer patients.
Main Results:
- Noninvasive functional biomarkers allow longitudinal monitoring of gastrointestinal damage and repair.
- Objective evidence for the efficacy of antimucositis agents can be collected in animal models.
- The C sucrose breath test demonstrates rapid monitoring of bioactive molecule efficacy in damage and repair cycles.
Conclusions:
- The C sucrose breath test is a valuable tool for monitoring chemotherapy-induced gastrointestinal damage and repair.
- This biomarker shows promise for evaluating new treatments in clinical trials and routine management of mucositis.
- Future applications may include predicting damage in other gastrointestinal regions, such as the oral mucosa.
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