Severe chronic nonlichenoid oral mucositis in pembrolizumab-treated patients: new cases and a review of the literature

To report of severe chronic oral mucositis (OM) in two pembrolizumab-treated cancer patients. A retrospective chart review was performed. Inclusion/exclusion criteria detected patients that developed OM during pembrolizumab immunotherapy. In addition, we searched the literature for nonlichenoid OM i...

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Bibliographic Details
Published in:Immunotherapy 2020-08, Vol.12 (11), p.777-784
Main Authors: Amy, Dalit Porat Ben, Shalabi, Akram, Finfter, Ori, Birenzweig, Yonatan, Zadik, Yehuda
Format: Article
Language:English
Subjects:
Adenocarcinoma
Astrocytoma
Cancer therapies
Case studies
Chemotherapy
Corticosteroids
Cytotoxicity
Drug dosages
Erythema
Immune system
Immunotherapy
Literature reviews
low-level laser therapy
Lung cancer
Lymphocytes
Metastasis
Monoclonal antibodies
Mucositis
oral complications
oral medicine
oral mucositis
oral oncology
Pain
Patients
Pembrolizumab
Radiation therapy
superficial mucocele
Targeted cancer therapy
Tongue
Ulcers
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Summary:To report of severe chronic oral mucositis (OM) in two pembrolizumab-treated cancer patients. A retrospective chart review was performed. Inclusion/exclusion criteria detected patients that developed OM during pembrolizumab immunotherapy. In addition, we searched the literature for nonlichenoid OM in immunotherapy-treated cancer patients. Two male patients treated for anaplastic astrocytoma and lung adenocarcinoma were included. Extensive painful OM (grade 4) developed in both patients during the course of immunotherapy and the ulcerations remained >30 weeks (>16 weeks after stopping immunotherapy). Superficial mucocele appeared in one patient. In one patient, pain relief was achieved with photobiomodulation (low-level laser) therapy. OM induced by immunotherapy may be a major cause of suffering and eating difficulties. In most cases, the OM lasted for months even after the drug was stopped. There is a controversy regarding the beneficial effect of corticosteroids on OM in these patients.
ISSN:1750-743X
1750-7448
DOI:10.2217/imt-2019-0162