Emerging therapies for the prevention and treatment of oral mucositis
1Brigham and Women's Hospital, Oral Medicine , 75 Francis Street, Boston, MA 02115 , USA.
Introduction:
Oral mucositis remains a common, symptomatically devastating toxicity of common drug and radiation regimens used to treat cancer. The current limited treatment options are likely to be supplemented by an active pipeline in which innovative compounds are being developed which target the underlying biological pathways associated with the condition.
Areas Covered:
A systematic literature search to identify English-language articles published from January 1995 to December 2013 was performed using the PubMed/MEDLINE and Google databases. A supplemental search was conducted of the ClinTrials database. Searches were driven by the following keywords: oral mucositis, mucositis, stomatitis, radiation therapy toxicity, chemotherapy toxicity, and risk prediction.
Expert Opinion:
Discovery and implementation of effective interventions for oral mucositis have been difficult. To date, in the U.S. only palifermin (Kepivance) have been approved and its use is currently confined to patients undergoing stem cell transplant, a very small portion of individuals at risk for mucositis. Fortunately, with the identification of a number of mechanistic pathways which underlie the mucositis' pathogenesis, a rich and diverse pipeline of both topical and systemic compounds are in various stages of pre-clinical and clinical development.
Insights
New treatments targeting the biological pathways of oral mucositis are emerging. While effective interventions remain challenging, a diverse pipeline of compounds shows promise for this common cancer treatment toxicity.
Area of Science:
- Oncology
- Pharmacology
- Oral Medicine
Background:
- Oral mucositis is a severe side effect of cancer therapies.
- Current treatments for oral mucositis are limited.
- Innovative compounds targeting biological pathways are under development.
Purpose of the Study:
- To review the landscape of oral mucositis treatments.
- To identify emerging therapeutic strategies for oral mucositis.
- To assess the development pipeline for new oral mucositis interventions.
Main Methods:
- Systematic literature search (PubMed/MEDLINE, Google, ClinTrials).
- Keywords included: oral mucositis, mucositis, stomatitis, radiation therapy toxicity, chemotherapy toxicity, risk prediction.
- English-language articles from January 1995 to December 2013 were reviewed.
Main Results:
- Discovery and implementation of effective oral mucositis interventions have been difficult.
- Palifermin (Kepivance) is the only FDA-approved drug, limited to stem cell transplant patients.
- Numerous mechanistic pathways underlying mucositis pathogenesis have been identified.
Conclusions:
- A rich pipeline of topical and systemic compounds is in development.
- These novel agents target identified mechanistic pathways of oral mucositis.
- Future treatments hold promise for managing this debilitating condition.
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