Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary Cancer
(1) Background: Immunotherapy-related adverse effects (irAEs) have been reported to manifest in oral tissues, mainly as lichenoid and non-lichenoid lesions and salivary gland dysfunction; however, the characterization of oral irAEs and their clinical impact is limited. (2) Methods: This is a retrosp...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/19/4781 |
| _version_ | 1797576113750278144 |
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| author | Sharon Elad Noam Yarom Yehuda Zadik |
| author_facet | Sharon Elad Noam Yarom Yehuda Zadik |
| author_sort | Sharon Elad |
| collection | DOAJ |
| description | (1) Background: Immunotherapy-related adverse effects (irAEs) have been reported to manifest in oral tissues, mainly as lichenoid and non-lichenoid lesions and salivary gland dysfunction; however, the characterization of oral irAEs and their clinical impact is limited. (2) Methods: This is a retrospective clinical chart review of 14 patients with oral irAEs, describing the impact of the oral irAEs in terms of the immediate effect, treatment, chronicity of the irAEs and the development of oral cancer. (3) Results: Common symptoms were pain and dry mouth, causing no-to-severe pain and/or dry mouth sensation. The immediate sequala ranged from sensitivity to certain foods up to elimination of oral intake. Treatment included conventional palliation techniques with or without systemic steroids. Discontinuation of the immunotherapy agents was required in 6 patients. Innovative treatment modalities included photobiomodulation for oral mucosal pain relief, and salivary gland intraductal irrigations for relief of salivary gland hypofunction. Late sequala included the development of proliferative leukoplakia and oral cancer. (4) Conclusions: Patients treated with immunotherapy may develop debilitating oral irAEs. They should be followed for oral involvement so treatment may be initiated when the symptoms are mild to avoid discontinuation of the immunotherapy. Patients that develop oral lichenoid lesions should receive long-term follow-up, as they may have higher risk for oral cancer. |
| first_indexed | 2024-03-10T21:47:45Z |
| format | Article |
| id | doaj.art-8a0e738c2add4dab912028d0fb4ec262 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T21:47:45Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-8a0e738c2add4dab912028d0fb4ec2622023-11-19T14:10:28ZengMDPI AGCancers2072-66942023-09-011519478110.3390/cancers15194781Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary CancerSharon Elad0Noam Yarom1Yehuda Zadik2Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14620, USAOral Medicine Unit, Sheba Medical Center, Tel Hashomer 5265601, IsraelDepartment of Oral Medicine, Sedation and Imaging, Faculty of Dental Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem 9112001, Israel(1) Background: Immunotherapy-related adverse effects (irAEs) have been reported to manifest in oral tissues, mainly as lichenoid and non-lichenoid lesions and salivary gland dysfunction; however, the characterization of oral irAEs and their clinical impact is limited. (2) Methods: This is a retrospective clinical chart review of 14 patients with oral irAEs, describing the impact of the oral irAEs in terms of the immediate effect, treatment, chronicity of the irAEs and the development of oral cancer. (3) Results: Common symptoms were pain and dry mouth, causing no-to-severe pain and/or dry mouth sensation. The immediate sequala ranged from sensitivity to certain foods up to elimination of oral intake. Treatment included conventional palliation techniques with or without systemic steroids. Discontinuation of the immunotherapy agents was required in 6 patients. Innovative treatment modalities included photobiomodulation for oral mucosal pain relief, and salivary gland intraductal irrigations for relief of salivary gland hypofunction. Late sequala included the development of proliferative leukoplakia and oral cancer. (4) Conclusions: Patients treated with immunotherapy may develop debilitating oral irAEs. They should be followed for oral involvement so treatment may be initiated when the symptoms are mild to avoid discontinuation of the immunotherapy. Patients that develop oral lichenoid lesions should receive long-term follow-up, as they may have higher risk for oral cancer.https://www.mdpi.com/2072-6694/15/19/4781adverse effectcancerimmunotherapylichen planusmucosaoral |
| spellingShingle | Sharon Elad Noam Yarom Yehuda Zadik Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary Cancer Cancers adverse effect cancer immunotherapy lichen planus mucosa oral |
| title | Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary Cancer |
| title_full | Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary Cancer |
| title_fullStr | Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary Cancer |
| title_full_unstemmed | Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary Cancer |
| title_short | Immunotherapy-Related Oral Adverse Effects: Immediate Sequelae, Chronicity and Secondary Cancer |
| title_sort | immunotherapy related oral adverse effects immediate sequelae chronicity and secondary cancer |
| topic | adverse effect cancer immunotherapy lichen planus mucosa oral |
| url | https://www.mdpi.com/2072-6694/15/19/4781 |
| work_keys_str_mv | AT sharonelad immunotherapyrelatedoraladverseeffectsimmediatesequelaechronicityandsecondarycancer AT noamyarom immunotherapyrelatedoraladverseeffectsimmediatesequelaechronicityandsecondarycancer AT yehudazadik immunotherapyrelatedoraladverseeffectsimmediatesequelaechronicityandsecondarycancer |