Research Progress in Pathogenesis and Clinical Management of EGFR-TKIs-related Oral Mucositis.

doi:10.13701/j.cnki.kqyxyj.2021.10.001

Abstract

Abstract: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are considered to be a landmark turning point in the treatment of lung cancer, which has substantially extended the survival time of patients. Oral mucositis (OM) is one of the common complications in the treatment of tumors with EGFR-TKIs, which is manifested as oral mucosal erythema, edema, erosion, and ulcers. The oral mucosa can be covered with pseudomembrane, oozed blood, and caused necrosis and pain, which seriously hindered food intake, reduced patients' nutrition and tolerance to treatment, and led to failure in patient's EGFR-TKIs treatment. The prevention and treatment of EGFR-TKIs-related oral mucositis is crucial to ensure the smooth progress of EGFR-TKIs treatment and improve the quality of life of patients. Based on the review of clinical manifestations and pathogenesis of EGFR-TKIs-related oral mucositis, this paper illustrates the prevention and management of EGFR-TKIs-related oral mucositis, and proposes the early discovery, early prevention, and full-process monitor of EGFR-TKIs-related oral mucositis in an effort to strengthen clinicians' awareness, thus facilitating the clinical application of EGFR-TKIs and other cancer-targeted drugs.

Key words: EGFR-TKIs, oral mucositis, clinical manifestations, mechanism, prevention and treatment

WANG Wenmei, DUAN Ning. Research Progress in Pathogenesis and Clinical Management of EGFR-TKIs-related Oral Mucositis.[J]. Journal of Oral Science Research, 2021, 37(10): 869-874.

References

[1] Shah RR, Shah DR. Safety and tolerability of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in oncology [J]. Drug Saf, 2019 ,42(2):181-198.
[2] Lehman CE, Mendez RE, Dougherty MI, et al. Survivin in insulin-like growth factor-induced resistance to lapatinib in head and neck squamous carcinoma cells [J]. Front Oncol,2019,9: 13.
[3] Califano R, Tariq N, Compton S, et al. Expert consensus on the management of adverse events from EGFR tyrosine kinase inhibitors in the UK [J]. Drugs,2015,75(12): 1335-1348.
[4] Vogel WH, Jennifer P. Management strategies for adverse events associated with EGFR TKIs in non-small cell lung cancer [J]. J Adv Pract Oncol, 2016, 7(7):723-735.
[5] Elad S, Cheng KKF, Lalla RV, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy [J]. Cancer, 2020, 126(19):4423-4431.
[6] 胡洁,林丽珠,骆肖群,等.EGFR-TKI不良反应管理专家共识[J].中国肺癌杂志,2019,22(2):57-81.
[7] Peterson DE, Boers-Doets CB, Bensadoun RJ, et al. Management of oral and gastrointestinal mucosal injury:ESMO clinical practice guidelines for diagnosis, treatment, and follow-up [J]. Ann Oncol, 2015, 26 (suppl 5): 139-151.
[8] Kato S, Saito A, Matsuda N, et al. Management of afatinib-induced stomatitis [J]. Mol Clin Oncol, 2017, 6(4):603-605.
[9] Lacouture M, Sibaud V. Toxic side effects of targeted therapies and immunotherapies affecting the skin, oral mucosa, hair, and nails [J]. Am J Clin Dermatol, 2018, 19(Suppl 1): 31-39.
[10] Vigarios E, Epstein JB, Sibaud V. Oral mucosal changes induced by anticancer targeted therapies and immune checkpoint inhibitors [J]. Support Care Cancer, 2017, 25(5): 1713-1739.
[11] Park K, Tan EH, O'Byrne K, et al. Afatinib versus gefitinib as first-line treatment of patients with EGFR mutation-positive non-small-cell lung cancer (LUX-Lung 7): a phase 2B, open-label, randomised controlled trial [J]. Lancet Oncol, 2016, 17(5): 577-589.
[12] Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma [J]. N Engl J Med, 2009, 361(10):947-957.
[13] Maemondo M, Inoue A, Kobayashi K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR [J]. N Engl J Med, 2010, 362(25): 2380-2388.
[14] Mitsudomi T, Morita S, Yatabe Y, et al. Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial [J]. Lancet Oncol, 2010, 11(2): 104-105.
[15] Rosell R, Carcereny E, Gervais R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial [J]. Lancet Oncol, 2012, 13(3):239-246.
[16] Wu YL, Zhou C, Hu CP, et al. Afatinib versus cisplatin plus gemcitabine for first-line treatment of Asian patients with advanced non-small-cell lung cancer harbouring EGFR mutations (LUX-Lung 6): an open-label, randomised phase 3 trial [J]. Lancet Oncol, 2014 ,15(2):213-222.
[17] Wu YL, Zhou C, Liam CK, et al. First-line erlotinib versus gemcitabine/cisplatin in patients with advanced EGFR mutation-positive non-small-cell lung cancer: analyses from the phase Ⅲ, randomized, open-label, ENSURE study [J]. Ann Oncol, 2015, 26(9): 1883-1889.
[18] Scagliotti GV, Parikh P, von Pawel J, et al. Phase Ⅲ study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer [J]. J Clin Oncol, 2008, 26(21):3543-3551.
[19] Shi YK, Wang L, Han BH, et al. First-line icotinib versus cisplatin/pemetrexed plus pemetrexed maintenance therapy for patients with advanced EGFR mutation-positive lung adenocarcinoma (CONVINCE): a phase 3, open-label, randomized study [J]. Ann Oncol, 2017, 28(10): 2443-2450.
[20] Sequist LV, Yang JC, Yamamoto N, et al. Phase Ⅲ study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations [J]. J Clin Oncol, 2013, 31(27):3327-3334.
[21] Melosky B, Leighl NB, Rothenstein J, et al. Management of egfr tki-induced dermatologic adverse events [J]. Curr Oncol, 2015, 22(2):123-132.
[22] Sonis ST. The pathobiology of mucositis [J]. Nat Rev Cancer, 2004, 4(4): 277-284.
[23] Rolf-P Ryseck, Attar R, Lorenzi MV, et al. Molecular pathology in oncology target and drug discovery [M]. John Wiley & Sons, Ltd, 2008.
[24] Arriola E, Reguart N, Artal A, et al. Management of the adverse events of afatinib: a consensus of the recommendations of the Spanish expert panel [J]. Future Oncol, 2015, 11(2):267-277.
[25] 刘婷,黄帆,王文梅.EGFR-TKIs药物相关口腔炎病例报告及相关文献复习[J].临床口腔医学杂志,2019,35(7):434-438.
[26] Amorim Dos Santos J, Normando AGC, de Toledo IP, et al. Laser therapy for recurrent aphthous stomatitis: an overview [J]. Clin Oral Investig, 2020, 24(1): 37-45.
[27] Sonis ST, Hashemi S, Epstein JB, et al. Could the biological robustness of low level laser therapy (Photobiomodulation) impact its use in the management of mucositis in head and neck cancer patients [J]. Oral Oncol, 2016, 54:7-14.
[28] Antunes HS, Herchenhorn D, Small IA, et al. Long-term survival of a randomized phase Ⅲ trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis [J]. Oral Oncol, 2017, 71:11-15.