Oral toxicities secondary to targeted therapies in patients with cancer: a large retrospective analysis

Targeted therapies (TT) have markedly improved oncology outcomes but are associated with adverse effects that can delay treatment and challenge clinicians. This large retrospective analysis investigates the prevalence and time to onset of oral toxicities from TT in patients with cancer.

Using de-identified data from PatientExploreR, which included 4,277,252 patient records, we analyzed cancer patients treated with 122 Food and Drug Administration-approved TT between January 2013 and December 2022. TT administration dates, patient demographics, and cancer diagnoses were recorded. Oral toxicities were identified using 83 predefined keywords.

The study included 12,660 patients (6,771 females-53.5%, 5,873 males-46.4%, and 16 unknown-0.1%) with a median age at TT administration of 55 years. "Malignant Neoplasms of Lymphoid, Hematopoietic, and Related Tissue" (n = 3,863; 30.5%) was the most common diagnosis group. Oral mucosal lesions were the most prevalent (4.5%), followed by dry mouth (1.1%). A significant difference was observed among the three types of oral toxicity in relation to time to onset (P < .01), age at TT administration (P < .001), race (P < .001), and smoking status (P < .001).

The rate of oral toxicities recorded in patient charts was consistently lower than the rates observed in prospective clinical trials. Approximately 5% of cancer patients experienced oral toxicities, with a slightly higher prevalence among females. Early identification and improved supportive care require a multidisciplinary approach.