Oral adverse events associated with targeted cancer therapies

Over the past decade, targeted therapies have emerged as promising forms of cancer treatment and are increasingly included in chemotherapeutic regimens for an ever-growing list of human cancers. Targeted therapies are so-named due to their specific targeting of dysregulated signaling pathways in cancer cells. This enhanced discrimination between tumor and normal cells is a more promising and efficacious approach to cancer treatment than conventional cytotoxic chemotherapy. However, targeted therapies still have side effects, and some manifest in the oral cavity. Oral adverse events tend to be mild and thus may be overlooked in the context of a patient's overarching diagnosis and management. These oral lesions are often noted during an intraoral examination and identified in the context of the patient's medical history and medication list. It is imperative that the dentist be informed of the oral sequelae of targeted therapies. Many of these side effects can be successfully managed in a palliative manner with conservative therapy. This article discusses the clinical presentations and treatment of intraoral adverse events attributable to the following classes of targeted therapies: epidermal growth factor receptor inhibitors, mammalian target of rapamycin inhibitors, angiogenesis inhibitors, and selected tyrosine kinase inhibitors.