Emerging therapies for the prevention and treatment of oral mucositis.

INTRODUCTION: Oral mucositis remains a common, symptomatically devastating toxicity of common drug and radiation regimens used to treat cancer. The current limited treatment options are likely to be supplemented by an active pipeline in which innovative compounds are being developed which target the underlying biological pathways associated with the condition. AREAS COVERED: A systematic literature search to identify English-language articles published from January 1995 to December 2013 was performed using the PubMed/MEDLINE and Google databases. A supplemental search was conducted of the ClinTrials database. Searches were driven by the following keywords: oral mucositis, mucositis, stomatitis, radiation therapy toxicity, chemotherapy toxicity, and risk prediction. EXPERT OPINION: Discovery and implementation of effective interventions for oral mucositis have been difficult. To date, in the U.S. only palifermin (Kepivance) have been approved and its use is currently confined to patients undergoing stem cell transplant, a very small portion of individuals at risk for mucositis. Fortunately, with the identification of a number of mechanistic pathways which underlie the mucositis' pathogenesis, a rich and diverse pipeline of both topical and systemic compounds are in various stages of pre-clinical and clinical development.