Systematic review of growth factors and cytokines for the management of oral mucositis in cancer patients and clinical practice guidelines.

Abstract

PURPOSE:

To update the clinical practice guidelines for the use of growth factors and cytokines for the prevention and/or treatment of oral mucositis (OM).

METHODS:

A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: recommendation, suggestion, and no guideline possible.

RESULTS:

A total of 15 new papers were identified within the scope of this section and were merged with 51 papers that were reviewed in the previous guidelines update. Of these, 14, 5, 13, 2, and 1 were randomized controlled trials about KGF-1, G-CSF, GM-CSF, EGF, and erythropoietin, respectively. For the remaining agents there were no new RCTs. The previous recommendation for intravenous KGF-1 in patients undergoing autologous hematopoietic stem cell transplantation (HSCT) conditioned with high-dose chemotherapy and TBI-based regimens is confirmed. The previous suggestion against the use of topical GM-CSF for the prevention of OM in the setting of high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation remains unchanged.

CONCLUSIONS:

Of the growth factors and cytokines studied for the management of OM, the evidence supports a recommendation in favor of KGF-1 and a suggestion against GM-CSF in certain clinical settings.

• Authors: Richard M Logan, Abdul Rahman Al-Azri, Paolo Bossi, Andrea M Stringer, Jamie K Joy, Yoshihiko Soga, Vinisha Ranna, Anusha Vaddi, Judith E Raber-Durlacher, Rajesh V Lalla, Karis Kin Fong Cheng, Sharon Elad, Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 28 Issue 5 Pg. 2485-2498 (May 2020) ISSN: 1433-7339 [Electronic] Germany
• PMID: 32080767 (Publication Type: Journal Article, Systematic Review)

Chemical References

• Antineoplastic Agents
• Cytokines
• Intercellular Signaling Peptides and Proteins
• Recombinant Proteins
• sargramostim
• Granulocyte-Macrophage Colony-Stimulating Factor

Topics

• Antineoplastic Agents (adverse effects, therapeutic use)
• Cytokines (therapeutic use)
• Granulocyte-Macrophage Colony-Stimulating Factor (therapeutic use)
• Humans
• Intercellular Signaling Peptides and Proteins (therapeutic use)
• Male
• Mucositis (drug therapy)
• Neoplasms (drug therapy)
• Practice Guidelines as Topic
• Recombinant Proteins (therapeutic use)
• Stomatitis (drug therapy)