Real-world management of oral mucositis/stomatitis among patients with advanced non-small cell lung cancer (NSCLC) or breast cancer (BC)

To describe United States real-world oral mucositis/stomatitis (OM/S) management for patients with non-small cell lung cancer (NSCLC) or breast cancer (BC) and document physician awareness of OM/S guidelines, risk factors, and barriers to care.
This study included a cross-sectional physician survey and retrospective chart review. Physicians completed an electronic survey and abstracted chart data for patients with advanced/metastatic NSCLC or BC who developed treatment-related OM/S on or after 1 January 2021.
Thirty-one physicians abstracted data for 272 patients (146 NSCLC; 126 BC). Median patient age at OM/S event was 66.2 years (NSCLC) and 61.6 years (BC). Systemic treatments included chemotherapy (NSCLC: 86.3%; BC: 67.5%), immunotherapy (NSCLC: 56.8%; BC: 10.3%), and targeted therapy (NSCLC: 9.6%; BC: 46.8%). OM/S-related treatment changes (reduction/interruption/discontinuation) were reported in 20.5% and 35.7% of patients with NSCLC or BC, respectively. A majority of physicians (61.3%) were unaware of published OM/S management guidelines. Physicians identified poor oral hygiene (80.6%) and limited physician awareness of OM/S guidelines (71.0%) as barriers to OM/S management.
OM/S occurs across cancer treatment regimens and can lead to treatment modification. Improvements in OM/S management at the patient and provider level are needed to enhance care and improve clinical outcomes.
What is this article about?
Chemotherapy, a type of cancer drug, is known to cause stomatitis (mouth sores) in some patients with cancer. Stomatitis can be very uncomfortable for patients and sometimes lead to changes in cancer treatment; several guidelines exist to help doctors prevent and manage them. New types of cancer drugs have been developed in recent years, but some also cause stomatitis and they are often given in combination with classical chemotherapy; no specific guidelines exist for stomatitis from these new drugs. This United States (US) study analyzed data for patients with breast or lung cancer who experienced stomatitis to see what treatments they were on, how severe the stomatitis was, and whether they had received any preventative treatments. It also surveyed doctors to understand what resources they use for stomatitis care.
What are the results?
Even though they see many patients with stomatitis, many US doctors were unfamiliar with current guidelines for preventing and managing stomatitis. Patients who developed stomatitis were on a wide range of cancer drugs, including non-chemotherapy treatments. While most patients had relatively mild cases of stomatitis, approximately a quarter had to lower the dose of their cancer treatment or change treatments due to stomatitis.
What do the results mean?
Patients continue to develop stomatitis from various types of cancer treatment, indicating that doctors and patients need additional guidelines to help manage stomatitis. Some stomatitis cases led to cancer treatment changes, indicating there is room for improvement to enhance care and improve clinical outcomes.