Stomatitis and EGFR-Tyrosine Kinase Inhibitors: A Review of Current Literature in 4353 Patients

Claudia Arena, Giuseppe Troiano, Khrystyna Zhurakivska, Riccardo Nocini and Lorenzo Lo Muzio

Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
Department of Surgical Sciences, University of Verona, Italy

^*Correspondance to: Lorenzo Lo Muzio 

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Abstract:

Conventional chemotherapy presents a wide range of side effects including oral toxicities such as hyposalivation, dysphagia, discomfort, taste alterations and mucositis. Oral complications often cause dose delays and interruptions of cancer treatment. EGFR is a member of the receptor tyrosine kinase ErbB family and a cell surface molecule whose activation leads to an intracellular signaling cascade promoting invasion, apoptosis and angiogenesis. Recent researches led to the development of a new drug class anti-EGFR, EGFR Tyrosine Kinase Inhibitors (TKI). The following review was performed to answer to the following question “Which is the rate of stomatitis in patients treated with EGFR TKI’s?” A systematic search was performed on the PubMed online database. Title and abstract of 102 potentially relevant studies were screened. Only 30 studies were included in the review. The overall incidence of stomatitis of any grade was 67.5% for erlotinib, 49.4% for afatinib, 40% for dacomitinib. These data showed a high rate of lower grade stomatitis. Indeed the rate of G1-G2 stomatitis was 59.3% in patients treated with erlotinib, 49.3% with afatinib and 35% with dacomitinib, while the rate of G3-G4 stomatitis was 15.3% in patients treated with erlotinib, 8.3% afatinib and 4.8% dacomitinib. Analysis of the reports about patients treated with EGFR-TKI showed a clear prevalence of stomatitis grade 1 or 2. These data differ from that of patients treated with conventional chemotherapy in which mucositis is predominantly of grade 3 or 4.

Keywords:

Stomatitis; EGFR-TKI; Mucositis; Target therapy; Oral medicine; Oral pathology

Cite the Article:

Arena C, Troiano G, Zhurakivska K, Nocini R, Muzio LL. Stomatitis and EGFR-Tyrosine Kinase Inhibitors: A Review of Current Literature in 4353 Patients. Clin Oncol. 2018; 3: 1549.