Emerging drugs for chemotherapy-induced mucositis

Background: Chemotherapy-induced mucositis is an increasingly recognized problem in cancer management, preventing full doses of treatment being given, compromising cure rates and reducing quality of life. Symptoms include mouth pain and ulceration, esophagitis, abdominal pain, bloating, and diarrhea. It is associated with increased infections and occasional mortality, and its palliation is very expensive. The pathobiology of mucositis is complex, and agents that target mechanisms to prevent mucositis or accelerate healing are in high demand. Objectives: To review existing and potential treatments for chemotherapy-induced mucositis in the context of current knowledge of pathobiology. Methods: We searched for mucositis of any region of the gastrointestinal tract using Medline, the Pharmaprojects database and listed patents. Results/conclusions: There are many agents in varying stages of development for chemotherapy-induced mucositis. The field is complicated by the question of whether treatments should be developed as drugs or as medical foods, and whether the burden of proof of efficacy and safety should be different.