ESTOMATITIS ASOCIADA A INHIBIDORES mTOR: PUESTA AL DÍA EN LA VALORACIÓN, PREVENCIÓN Y MANEJO.
ESTOMATITIS ASOCIADA A INHIBIDORES mTOR.
DOI:
https://doi.org/10.37395/seeo.2021.0004Palabras clave:
Estomatitis; Serina-Treonina Quinasas TOR/antagonistas e inhibidores; Efectos colaterales y reacciones adversas relacionadas con medicamentos; Evaluación de síntomas; Revisión; Enfermería basada en la evidencia.Resumen
La estomatitis asociada al tratamiento con inhibidores mTOR (EAIm) es un evento adverso que puede ser confundido con la mucositis asociada a la quimioterapia convencional. Ambos son procesos diferentes que requieren abordajes diferentes por parte del personal de enfermería. La correcta identificación y manejo de la EAIm favorecería una mejora en la calidad de vida del paciente, la resolución temprana de las lesiones y la continuidad del tratamiento.
En este artículo presentamos una puesta al día del conocimiento disponible sobre la valoración, prevención y manejo de esta complicación, basándonos en la evidencia disponible y en las recomendaciones facilitadas por las principales guías clínicas. Además, dado que no existe un cuerpo de conocimiento suficientemente desarrollado, analizamos las posibles implicaciones que puede tener para la investigación.
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1. Martins F, de Oliverira MA, Wang Q, Sonis S, Gallotini M, George S, Treister N. A review of oral toxicity associated with mTOR inhibitor therapy in cancer patients. Oral Oncol 2013; 49(4): 293-8. DOI: 10.1016/j.oraloncology.2012.11.008
2. Watters AL, Epstein JB, Agulnik M. Oral complications of targeted cancer therapies: a narrative literature review. Oral Oncol 2011; 47(6): 441-448. DOI: 10.1016/j.oraloncology.2011.03.028
3. Boers-Doets CB, Raber-Durlacher JE, Treister NS, et al. Mammalian target of rapamycin inhibitor-associated stomatitis. Future Oncol 2013; 9: 1883-1892. DOI: 10.2217/fon.13.141
4. Li E, Trovato JA. New developments in management of oral mucositis in patients with head and neck cancer or receiving targeted anticancer therapies. Am J Health Syst Pharm 2012; 69(12): 1031-7. DOI: 10.2146/ajhp100531
5. Sonis ST. Oral mucositis. Anticancer Drugs 2011; 22(7): 607-12. DOI: 10.1097/CAD.0b013e3283462086
6. Scully C. Aphthosus ulceration. N Engl J Med 2006; 355(2): 165-172. DOI: 10.1056/NEJMcp054630
7. Sonis S, Treister N, Chawla S, Demetri G, Haluska F. Preliminary characterization of oral lesions associated with inhibitors of mammaliam target of rapamycin in cancer patients. Cancer 2010; 116(1): 210-5. DOI: 10.1002/cncr.24696
8. de Oliveira MA, Martins e Martins F, Wang Q, Sonis S, Demetri G, George S, Butrynski J, Treister NS. Clinical presentation and management of mTOR inhibitor-associated stomatitis. Oral Oncol 2011; 47(10): 998-1003. DOI: 10.1016/j.oraloncology.2011.08.009
9. Ferté C, Paci A, Zizi M, Gonzales DB, Goubar A, Gomez-Roca C, Massard C, Sahmoud T, André F, Soria JC. Natural history, management and pharmacokinetics of everolimus-induced-oral ulcers: insights into compliance issues. Eur J Cancer 2011; 47(15): 2249-55. DOI: 10.1016/j.ejca.2011.03.017
10. Shameem R, Lacouture M, Wu S. Incidence and risk of high-grade stomatitis with mTOR inhibitors in cancer patients. Cancer Invest 2015; 33(3): 70-7. DOI: 10.3109/07357907.2014.1001893
11. Kalogirou EM, Tosios KI, Piperi EP, Sklavounou A. mTOR inhibitor-associated stomatitis (mIAS) in three patients with cancer treated with everolimus. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119(1): e13-9. DOI: 10.1016/j.oooo.2014.08.023
12. Peterson DE, Boers-Doets CB, Bensadoun RJ, Herrstedt J, ESMO Guidelines Committee. Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Ann Oncol 2015; Suppl 5: v139-51. DOI: 10.1093/annonc/mdv202
13. Boers-Doets CB, Lalla RV. The mIAS scale: a scale to measure mTOR inhibitor-associated stomatitis. Support Care Cancer 2013; 21(S1): S140. Disponible en: https://www.researchgate.net/publication/259802622_The_mIAS_scale_a_scale_to_measure_mTOR_inhibitor-associated_stomatitis
14. Lo Muzio L, Arena C, Troiano G, Villa A. Oral stomatitis and mTOR inhibitors: a review of current evidence in 20,915 patients. Oral Dis 2018; 24(1-2): 144-171. DOI: 10.1111/odi.12795
15. Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, McGuire DB, Migliorati C, Nicolatou-Galitis O, Peterson DE, Raber-Durlacher JE, Sonis ST, Elad S. Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 2014; 120(10): 1453-61. DOI: 10.1002/cncr.28592
16. McGuire DB, Fulton JS, Park J, Brown CG, Correa ME, Eilers J, Elad S, Gibson F, Oberle-Edwards LK, Bowen J, Lalla RV; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Systematic review of basic oral care for the management of oral mucositis in cancer patients. Support Care Cancer 2013; 21(11): 3167-77. DOI: 10.1007/s00520-013-1942-0
17. Malizzia LJ, Hsu A. Temsirolimus, an mTOR inhibitor for treatment of patients with advanced renal cell carcinoma. Clin J Oncol Nurs 2008; 12: 639-46. DOI: 10.1188/08.CJON.639-646
18. Pilotte AP, Hohos MB, Polson KM, Huftalen TM, Treister N. Managing stomatitis in patients treated with mammalian target of rapamycin inhibitors. Clin J Oncol Nurs 2011; 15(5): E83-9. DOI: 10.1188/11.CJON.E83-E89
19. Peterson E, O’Shaughnessy JA, Rugo HS, Elad S, Schubert MM, Viet CT, Campbell-Baird C, Hronek J, Seery V, Divers J, Glaspy J, Schmidt BL, Meiller TF. Oral mucosa injury caused by mammalian target of rapamycin inhibitors: emerging perspectives on pathobiology and impact on clinical practice. Cancer Med 2016; 5(8): 1897-907. DOI: 10.1002/cam4.761
20. Chuang P, Langone AJ. Clobetasol ameliorates aphthosus ulceration in renal transplant patients on sirolimus. Am J Transplant 2007; 7(3): 714-7. DOI: 10.1111/j.1600-6143.2006.01678.x
21. Meiller TF, Varlotta S, Weikel D. Recognition and management of oral mucosal injury caused by mammalian target of rapamycin inhibitors: a case series. Case Rep Oncol 2015; 8(2): 369-77. DOI: 10.1159/000438747
22. Dy GK, Adjei AA. Understanding, recognizing, and managing toxicities of targeted anticancer therapies. CA Cancer J Clin 2013; 63(4): 249-79. DOI: 10.3322/caac.21184
23. Aapro M, Andre F, Blackwell K, Calvo E, Jahanzeb M, Papazisis K, Porta C, Pritchard K, Ravaud A. Adverse event management in patients with advanced cancer receiving oral everolimus: focus on breast cancer. Ann Oncol 2014; 25(4): 763-773. DOI: 10.1093/annonc/mdu021
24. Porta C, Osanto S, Ravaud A, Climent MA, Vaishampayan U, White DA, Creel P, Dickow B, Fischer P, Gornell SS, Meloni F, Motzer RJ. Management of adverse events associated with the use of everolimus in patients with advanced renal cell carcinoma. Eur J Cancer 2011; 47(9): 1287-98. DOI: 10.1016/j.ejca.2011.02.014
2. Watters AL, Epstein JB, Agulnik M. Oral complications of targeted cancer therapies: a narrative literature review. Oral Oncol 2011; 47(6): 441-448. DOI: 10.1016/j.oraloncology.2011.03.028
3. Boers-Doets CB, Raber-Durlacher JE, Treister NS, et al. Mammalian target of rapamycin inhibitor-associated stomatitis. Future Oncol 2013; 9: 1883-1892. DOI: 10.2217/fon.13.141
4. Li E, Trovato JA. New developments in management of oral mucositis in patients with head and neck cancer or receiving targeted anticancer therapies. Am J Health Syst Pharm 2012; 69(12): 1031-7. DOI: 10.2146/ajhp100531
5. Sonis ST. Oral mucositis. Anticancer Drugs 2011; 22(7): 607-12. DOI: 10.1097/CAD.0b013e3283462086
6. Scully C. Aphthosus ulceration. N Engl J Med 2006; 355(2): 165-172. DOI: 10.1056/NEJMcp054630
7. Sonis S, Treister N, Chawla S, Demetri G, Haluska F. Preliminary characterization of oral lesions associated with inhibitors of mammaliam target of rapamycin in cancer patients. Cancer 2010; 116(1): 210-5. DOI: 10.1002/cncr.24696
8. de Oliveira MA, Martins e Martins F, Wang Q, Sonis S, Demetri G, George S, Butrynski J, Treister NS. Clinical presentation and management of mTOR inhibitor-associated stomatitis. Oral Oncol 2011; 47(10): 998-1003. DOI: 10.1016/j.oraloncology.2011.08.009
9. Ferté C, Paci A, Zizi M, Gonzales DB, Goubar A, Gomez-Roca C, Massard C, Sahmoud T, André F, Soria JC. Natural history, management and pharmacokinetics of everolimus-induced-oral ulcers: insights into compliance issues. Eur J Cancer 2011; 47(15): 2249-55. DOI: 10.1016/j.ejca.2011.03.017
10. Shameem R, Lacouture M, Wu S. Incidence and risk of high-grade stomatitis with mTOR inhibitors in cancer patients. Cancer Invest 2015; 33(3): 70-7. DOI: 10.3109/07357907.2014.1001893
11. Kalogirou EM, Tosios KI, Piperi EP, Sklavounou A. mTOR inhibitor-associated stomatitis (mIAS) in three patients with cancer treated with everolimus. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119(1): e13-9. DOI: 10.1016/j.oooo.2014.08.023
12. Peterson DE, Boers-Doets CB, Bensadoun RJ, Herrstedt J, ESMO Guidelines Committee. Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Ann Oncol 2015; Suppl 5: v139-51. DOI: 10.1093/annonc/mdv202
13. Boers-Doets CB, Lalla RV. The mIAS scale: a scale to measure mTOR inhibitor-associated stomatitis. Support Care Cancer 2013; 21(S1): S140. Disponible en: https://www.researchgate.net/publication/259802622_The_mIAS_scale_a_scale_to_measure_mTOR_inhibitor-associated_stomatitis
14. Lo Muzio L, Arena C, Troiano G, Villa A. Oral stomatitis and mTOR inhibitors: a review of current evidence in 20,915 patients. Oral Dis 2018; 24(1-2): 144-171. DOI: 10.1111/odi.12795
15. Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, McGuire DB, Migliorati C, Nicolatou-Galitis O, Peterson DE, Raber-Durlacher JE, Sonis ST, Elad S. Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 2014; 120(10): 1453-61. DOI: 10.1002/cncr.28592
16. McGuire DB, Fulton JS, Park J, Brown CG, Correa ME, Eilers J, Elad S, Gibson F, Oberle-Edwards LK, Bowen J, Lalla RV; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Systematic review of basic oral care for the management of oral mucositis in cancer patients. Support Care Cancer 2013; 21(11): 3167-77. DOI: 10.1007/s00520-013-1942-0
17. Malizzia LJ, Hsu A. Temsirolimus, an mTOR inhibitor for treatment of patients with advanced renal cell carcinoma. Clin J Oncol Nurs 2008; 12: 639-46. DOI: 10.1188/08.CJON.639-646
18. Pilotte AP, Hohos MB, Polson KM, Huftalen TM, Treister N. Managing stomatitis in patients treated with mammalian target of rapamycin inhibitors. Clin J Oncol Nurs 2011; 15(5): E83-9. DOI: 10.1188/11.CJON.E83-E89
19. Peterson E, O’Shaughnessy JA, Rugo HS, Elad S, Schubert MM, Viet CT, Campbell-Baird C, Hronek J, Seery V, Divers J, Glaspy J, Schmidt BL, Meiller TF. Oral mucosa injury caused by mammalian target of rapamycin inhibitors: emerging perspectives on pathobiology and impact on clinical practice. Cancer Med 2016; 5(8): 1897-907. DOI: 10.1002/cam4.761
20. Chuang P, Langone AJ. Clobetasol ameliorates aphthosus ulceration in renal transplant patients on sirolimus. Am J Transplant 2007; 7(3): 714-7. DOI: 10.1111/j.1600-6143.2006.01678.x
21. Meiller TF, Varlotta S, Weikel D. Recognition and management of oral mucosal injury caused by mammalian target of rapamycin inhibitors: a case series. Case Rep Oncol 2015; 8(2): 369-77. DOI: 10.1159/000438747
22. Dy GK, Adjei AA. Understanding, recognizing, and managing toxicities of targeted anticancer therapies. CA Cancer J Clin 2013; 63(4): 249-79. DOI: 10.3322/caac.21184
23. Aapro M, Andre F, Blackwell K, Calvo E, Jahanzeb M, Papazisis K, Porta C, Pritchard K, Ravaud A. Adverse event management in patients with advanced cancer receiving oral everolimus: focus on breast cancer. Ann Oncol 2014; 25(4): 763-773. DOI: 10.1093/annonc/mdu021
24. Porta C, Osanto S, Ravaud A, Climent MA, Vaishampayan U, White DA, Creel P, Dickow B, Fischer P, Gornell SS, Meloni F, Motzer RJ. Management of adverse events associated with the use of everolimus in patients with advanced renal cell carcinoma. Eur J Cancer 2011; 47(9): 1287-98. DOI: 10.1016/j.ejca.2011.02.014
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Publicado
2021-01-24
Cómo citar
Arevalo-Manso, J. J., Navarro-Ruiz, J. I., Arévalo-de Frutos, C., Hernández-Sánchez, S., Álvaro-Miguel, M. J., & Coto-Linde, R. (2021). ESTOMATITIS ASOCIADA A INHIBIDORES mTOR: PUESTA AL DÍA EN LA VALORACIÓN, PREVENCIÓN Y MANEJO.: ESTOMATITIS ASOCIADA A INHIBIDORES mTOR. Enfermería Oncológica, 23(1), 29–41. https://doi.org/10.37395/seeo.2021.0004
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