Emerging pharmacotherapy trends in preventing and managing oral mucositis induced by chemoradiotherapy and targeted agents

Margherita Gobbo, Jamie Joy, Helena Guedes, Muhamed Alì Shazib, Carryn Anderson, Ragda Abdalla-Aslan, Khunthong Peechatanan, Carlo Lajolo, Khawaja Shehryar Nasir, Luiz Alcino Gueiros, Nivethitha Nagarajan, Kimia Hafezi Motlagh, Abhishek Kandwal, Cosimo Rupe, Yuanming Xu, Eli D. Ehrenpreis, Arghavan Tonkaboni, Joel B. Epstein, Paolo Bossi, Hannah R. WardillStephanie L. Graff

Research output: Contribution to journalReview articlepeer-review


Introduction: The introduction of targeted therapy and immunotherapy has tremendously changed the clinical outcomes and prognosis of cancer patients. Despite innovative pharmacological therapies and improved radiotherapy (RT) techniques, patients continue to suffer from side effects, of which oral mucositis (OM) is still the most impactful, especially for quality of life. Areas Covered: We provide an overview of current advances in cancer pharmacotherapy and RT, in relation to their potential to cause OM, and of the less explored and more recent literature reports related to the best management of OM. We have analyzed natural/antioxidant agents, probiotics, mucosal protectants and healing coadjuvants, pharmacotherapies, immunomodulatory and anticancer agents, photobiomodulation and the impact of technology. Expert Opinion: The discovery of more precise pathophysiologic mechanisms of CT and RT-induced OM has outlined that OM has a multifactorial origin, including direct effects, oxidative damage, upregulation of immunologic factors, and effects on oral flora. A persistent upregulated immune response, associated with factors related to patients’ characteristics, may contribute to more severe and long-lasting OM. The goal is strategies to conjugate individual patient, disease, and therapy-related factors to guide OM prevention or treatment. Despite further high-quality research is warranted, the issue of prevention is paramount in future strategies.

Original languageEnglish
JournalExpert Opinion on Pharmacotherapy
Publication statusAccepted/In press - 2024


  • Chemotherapy
  • oral mucositis
  • pharmacotherapy
  • radiotherapy
  • targeted therapy

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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