Oral mucositis. Is it present in the immunotherapy of the immune checkpoint pd1/pd-l1 against oral cancer? A systematic review

• Juan Francisco Peña-Cardelles ^[1] ; Angel Orión Salgado-Peralvo ^[2] ; Pablo Garrido-Martínez ^[3] ; José Luis Cebrián-Carretero ^[4] ; José Juan Pozo-Kreilinger ^[5] ; José Ernesto Moro-Rodríguez ^[1]
  1. [1] Universidad Rey Juan Carlos

     Universidad Rey Juan Carlos

     Madrid, España

     
  2. [2] Universidad de Sevilla

     Universidad de Sevilla

     Sevilla, España

     
  3. [3] Associate Professor. Department of Prosthesis, Faculty of Dentistry, University Alfonso X el Sabio, Madrid, Spain; Department of Oral and Maxillofacial Surgery, Hospital La Luz, Madrid, Spain
  4. [4] Chief. Department of Oral and Maxillofacial Surgery, Hospital La Luz, Madrid, Spain; Chief of Section. Department of Oral and Maxillofacial Surgery, Hospital Universitario La Paz, Madrid, Spain
  5. [5] Associate Professor of Medicine. Department of Pathology. Universidad Autónoma de Madrid, Spain; Hospital Universitario La Paz, Madrid, Spain

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 26, Nº. 4, 2021
• Idioma: inglés
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• Resumen

  • Oral mucositis (OM) is a painful lesion that takes place in the mucosa of the oral cavity, usually its etiology is associated with drug therapies in cancer patients. It is presented as well-defined ulcers whose painful symptomatology sometimes implies the suspension of oncological treatment or parenteral feeding, being therefore an important adverse effect, marking the evolution of these types of therapies against cancer. The present work aim is to know the prevalence of oral mucositis in oral cancer immunotherapy compared to its prevalence in standard therapy.

    A protocol was developed for a systematic review following PRISMA® guidelines and a focused question (PICO) was constructed. A comprehensive literature search was conducted on electronic databases including PubMed, the SCOPUS database, the Cochrane library and the Web of Science (WOS).

    Six clinical trials were included that met the different inclusion criteria. In these articles, a discrepancy between the prevalence of OM in patients treated with chemotherapy and patients treated with immunotherapy related to the immune checkpoint PD-1/PD-L1 (Nivolumab and Pembrolizumab) was observed.

    The prevalence of oral mucositis is lower in new immunotherapy with monoclonal antibodies against oral cancer than drugs used so far (chemotherapy drugs [methotrexate, cisplatin] as well as cetuximab). However, more studies should be carried out to confirm these data.