Stomatitis and VEGFR-Tyrosine Kinase Inhibitors (VR-TKIs): A Review of Current Literature in 4369 Patients

• Published in: BioMed research international 2018-01, Vol.2018 (2018), p.1-16
• Main Authors: Testa, Nunzio F., De Lillo, Alfredo, Troiano, Giuseppe, Arena, Claudia, Lo Muzio, Lorenzo
• Format: Article
• Language: English
• Subjects: Angiogenesis; Anorexia; Antimitotic agents; Antineoplastic agents; Antineoplastic Agents - adverse effects; Antineoplastic drugs; Appetite loss; Asthenia; Boolean algebra; Brain cancer; Cancer; Cancer therapies; Chemotherapy; Diarrhea; Endothelial growth factors; English language; Epidermal growth factor; Fatigue; Gene expression; Humans; Hypertension; Hypothyroidism; Incidence; Inhibitors; Ionizing radiation; Kinases; Literature reviews; Medical research; Medical Subject Headings-MeSH; Melanoma; Metastasis; Mucositis; Myelosuppression; Online databases; Pain; Patients; Permeability; Phenols; Protein Kinase Inhibitors - adverse effects; Protein-Tyrosine Kinases; Review; Skin cancer; Stomatitis; Stomatitis - chemically induced; Taste disorders; Thyroid cancer; Thyroid hormones; Tyrosine; Tyrosine kinase inhibitors; Vascular endothelial growth factor; Vascular endothelial growth factor receptors
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2018/5035217

Background. Multitargeted tyrosine kinase inhibitors (TKIs) represent a new class of target-specific antineoplastic agents. These agents show some specific adverse events such as fatigue/asthenia, anorexia/loss of appetite, dysgeusia, diarrhea/abdominal pain, hypothyroidism, hypertension, myelosuppression, and stomatitis. Materials and Methods. A systematic search was performed on PubMed online database using a combination of MESH terms and free text words, “sunitinib” OR “sorafenib” OR “axitinib” OR “cabozantinib” OR “pazopanib” OR “regorafenib” OR “nintedanib” OR “vatalanib” combined through the use of Boolean operator AND with the key words “stomatitis” OR “mucositis,” (i) on human subjects, (ii) written in the English language, and (iii) reporting about the incidence of stomatitis or oral mucositis. Results. The incidence of stomatitis of any grade was 35.2% for sunitinib, 20.52% for sorafenib, 20.63% for axitinib, and 34.21% for cabozantinib. All the agents showed high rates of low-grade stomatitis (G1-G2), while the onset of severe stomatitis (G3-G4) was very low. Conclusions. Analysis of the reports with patients treated with sunitinib, sorafenib, axitinib, and cabozantinib showed a clear prevalence of stomatitis grade 1 or grade 2. These data differ from those of patients treated with conventional chemotherapy in which mucositis is predominantly of grade 3 or grade 4.