Regimen-Related Oral Mucosal Injury: Pathobiology, Clinical Consequences and Rationale for Intervention Across Cancer...

Area of Science:

• Oncology
• Gastroenterology
• Pharmacology

Background:

• Mucosal injury, or mucositis, is a common and debilitating side effect of cancer treatments.
• Current treatment options for mucositis are limited, representing a significant unmet clinical need.
• This toxicity affects the entire alimentary tract, including the oral cavity.

Purpose of the Study:

• To provide a comparative discussion of the pathobiology, clinical features, and risk factors of regimen-related mucosal injury.
• To use oral mucositis as a model to understand mucosal injury across different therapy classes.
• To identify commonalities in the pathobiology of mucositis induced by conventional and emerging cancer therapies.

Main Methods:

• Literature review focusing on regimen-related toxicities.
• Comparative analysis of mucositis across conventional cytotoxic chemotherapy, radiotherapy, targeted agents, immunotherapy, and antibody-drug conjugates.
• Assessment of pathobiological underpinnings and clinical features.

Main Results:

• Mucosal injury is a collateral damage from various cancer therapies, not limited to conventional agents.
• Persistent challenges hinder the development of effective, mechanistically-based treatments for mucositis.
• Regimen-related toxicities often occur in clusters, suggesting common pathobiological mechanisms.

Conclusions:

• Understanding common pathobiological underpinnings is crucial for developing unified, systemic mitigation strategies for mucositis.
• Further research is needed to address the unmet clinical need for effective mucositis treatments.
• Emerging cancer therapies also contribute to mucosal injury, necessitating a broader approach to management.