H R Wardill1,2, S T Sonis3,4, N M A Blijlevens5, Y Z A Van Sebille6, M A Ciorba7, E A H Loeffen8, K K F Cheng9, P Bossi10, L Porcello11, D A Castillo12, S Elad13, J M Bowen14. 1. Adelaide Medical School, University of Adelaide, Helen Mayo Building (Adelaide Medical School) Frome Road, Adelaide, South Australia, 5005, Australia. Hannah.wardill@adelaide.edu.au. 2. Department of Pediatric Oncology/Hematology, The University of Groningen, University Medical Centre Groningen (Beatrix Children's Hospital), Groningen, The Netherlands. Hannah.wardill@adelaide.edu.au. 3. Brigham and Women's Hospital and the Dana-Farber Cancer Institute, Boston, MA, USA. 4. Primary Endpoint Solutions, LLC, Waltham, MA, USA. 5. Department of Hematology, Radboud University Medical Centre, Nijmegen, The Netherlands. 6. Division of Health Sciences, The University of South Australia, Adelaide, Australia. 7. Inflammatory Bowel Diseases Center, Division of Gastroenterology, Washington University in Saint Louis, Saint Louis, MO, USA. 8. Department of Pediatric Oncology/Hematology, The University of Groningen, University Medical Centre Groningen (Beatrix Children's Hospital), Groningen, The Netherlands. 9. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 10. Department of Medical and Surgical Specialties, Radiological Sciences and Public Health - Medical Oncology, ASST-Spedali Civili, University of Brescia, Brescia, Italy. 11. Eastman Institute for Oral Health, Basil G. Bibby Library, Rochester, NY, USA. 12. Edward G. Miner Library, University of Rochester Medical Center, Rochester, NY, USA. 13. Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA. 14. Adelaide Medical School, University of Adelaide, Helen Mayo Building (Adelaide Medical School) Frome Road, Adelaide, South Australia, 5005, Australia.
Abstract
PURPOSE: Despite advances in personalizing the efficacy of cancer therapy, our ability to identify patients at risk of severe treatment side effects and provide individualized supportive care is limited. This is particularly the case for mucositis (oral and gastrointestinal), with no comprehensive risk evaluation strategies to identify high-risk patients. We, the Multinational Association for Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) Mucositis Study Group, therefore aimed to systematically review current evidence on that factors that influence mucositis risk to provide a foundation upon which future risk prediction studies can be based. METHODS: We identified 11,018 papers from PubMed and Web of Science, with 197 records extracted for full review and 113 meeting final eligibility criteria. Data were then synthesized into tables to highlight the level of evidence for each risk predictor. RESULTS: The strongest level of evidence supported dosimetric parameters as key predictors of mucositis risk. Genetic variants in drug-metabolizing pathways, immune signaling, and cell injury/repair mechanisms were also identified to impact mucositis risk. Factors relating to the individual were variably linked to mucositis outcomes, although female sex and smoking status showed some association with mucositis risk. CONCLUSION: Mucositis risk reflects the complex interplay between the host, tumor microenvironment, and treatment specifications, yet the large majority of studies rely on hypothesis-driven, single-candidate approaches. For significant advances in the provision of personalized supportive care, coordinated research efforts with robust multiplexed approaches are strongly advised.
PURPOSE: Despite advances in personalizing the efficacy of cancer therapy, our ability to identify patients at risk of severe treatment side effects and provide individualized supportive care is limited. This is particularly the case for mucositis (oral and gastrointestinal), with no comprehensive risk evaluation strategies to identify high-risk patients. We, the Multinational Association for Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) Mucositis Study Group, therefore aimed to systematically review current evidence on that factors that influence mucositis risk to provide a foundation upon which future risk prediction studies can be based. METHODS: We identified 11,018 papers from PubMed and Web of Science, with 197 records extracted for full review and 113 meeting final eligibility criteria. Data were then synthesized into tables to highlight the level of evidence for each risk predictor. RESULTS: The strongest level of evidence supported dosimetric parameters as key predictors of mucositis risk. Genetic variants in drug-metabolizing pathways, immune signaling, and cell injury/repair mechanisms were also identified to impact mucositis risk. Factors relating to the individual were variably linked to mucositis outcomes, although female sex and smoking status showed some association with mucositis risk. CONCLUSION:Mucositis risk reflects the complex interplay between the host, tumor microenvironment, and treatment specifications, yet the large majority of studies rely on hypothesis-driven, single-candidate approaches. For significant advances in the provision of personalized supportive care, coordinated research efforts with robust multiplexed approaches are strongly advised.
Authors: Julia S Bruno; Vitor Heidrich; Franciele H Knebel; Vinícius Campos de Molla; Claudia Joffily Parahyba; Wanessa Miranda-Silva; Paula F Asprino; Luciana Tucunduva; Vanderson Rocha; Yana Novis; Celso Arrais-Rodrigues; Anamaria A Camargo; Eduardo R Fregnani Journal: Sci Rep Date: 2022-10-20 Impact factor: 4.996
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