TY - JOUR
T1 - Oral Toxicities Associated with Immune Checkpoint Inhibitors
T2 - Meta-Analyses of Clinical Trials
AU - Srivastava, Akanksha
AU - Nogueras-Gonzalez, Graciela M.
AU - Geng, Yimin
AU - Singh, Jasdev
AU - Myers, Jeffrey N
AU - Li, Yisheng
AU - Chambers, Mark S
N1 - Publisher Copyright:
© 2024, Innovative Healthcare Institute. All rights reserved.
PY - 2024/2
Y1 - 2024/2
N2 - Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, their oral toxicity profile is not well elucidated. This review aimed to investigate the prevalence of oral toxicities including xerostomia, mucositis/stomatitis, dysgeusia, dysphagia, oral/oropharyngeal pain, oral infections, angular cheilitis, osteonecrosis, osteomyelitis, and oral mucosal reactions with ICIs. A review protocol was registered with PROSPERO (ID: CRD42023391674). A systematic search of ClinicalTrials.gov was conducted as of April 10, 2022. Studies were selected, assessed, and data extracted using PRISMA guidelines. Oral toxicity data were extracted from study arms using a single immunotherapy drug. Meta-analyses were conducted to summarize prevalence of oral toxicities using random-effects models. Of 750 screened records, 95 trials were included in the meta-analysis with published results. Time between study completion and first publication on ClinicalTrials.gov was 1 to 146 months (mean = 20.3, SD = 18.4). Weighted pooled prevalence was 5% (95% CI: 4–6%) for xerostomia, 3% (95% CI: 3–4%) for mucositis/stomatitis, 3% (95% CI: 2–3%) for dysgeusia, 2% (95% CI: 1–2%) for dysphagia, 3% (95% CI: 2–4%) for oropharyngeal/oral pain, 2% (95% CI: 1–3%) for oral candidiasis, and 2% (95% CI: 0–4%) for angular cheilitis. Subgroup differences based on ICI drugs were minimal. No trials reported lichenoid or pemphigoid mucosal reactions. Meta-analysis results revealed low prevalence of oral toxicities with ICIs; however, data reporting was limited and inconsistent. Limitations of study dataset reveal a significant need for systematic collection of oral morbidity data as well as improved consistency and compliance of reporting results on ClinicalTrials.gov.
AB - Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, their oral toxicity profile is not well elucidated. This review aimed to investigate the prevalence of oral toxicities including xerostomia, mucositis/stomatitis, dysgeusia, dysphagia, oral/oropharyngeal pain, oral infections, angular cheilitis, osteonecrosis, osteomyelitis, and oral mucosal reactions with ICIs. A review protocol was registered with PROSPERO (ID: CRD42023391674). A systematic search of ClinicalTrials.gov was conducted as of April 10, 2022. Studies were selected, assessed, and data extracted using PRISMA guidelines. Oral toxicity data were extracted from study arms using a single immunotherapy drug. Meta-analyses were conducted to summarize prevalence of oral toxicities using random-effects models. Of 750 screened records, 95 trials were included in the meta-analysis with published results. Time between study completion and first publication on ClinicalTrials.gov was 1 to 146 months (mean = 20.3, SD = 18.4). Weighted pooled prevalence was 5% (95% CI: 4–6%) for xerostomia, 3% (95% CI: 3–4%) for mucositis/stomatitis, 3% (95% CI: 2–3%) for dysgeusia, 2% (95% CI: 1–2%) for dysphagia, 3% (95% CI: 2–4%) for oropharyngeal/oral pain, 2% (95% CI: 1–3%) for oral candidiasis, and 2% (95% CI: 0–4%) for angular cheilitis. Subgroup differences based on ICI drugs were minimal. No trials reported lichenoid or pemphigoid mucosal reactions. Meta-analysis results revealed low prevalence of oral toxicities with ICIs; however, data reporting was limited and inconsistent. Limitations of study dataset reveal a significant need for systematic collection of oral morbidity data as well as improved consistency and compliance of reporting results on ClinicalTrials.gov.
KW - dysgeusia
KW - dysphagia
KW - immune checkpoint inhibitors
KW - immune-related oral toxicities
KW - mucositis
KW - oral adverse events
UR - http://www.scopus.com/inward/record.url?scp=85184915188&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85184915188&partnerID=8YFLogxK
U2 - 10.36401/JIPO-23-14
DO - 10.36401/JIPO-23-14
M3 - Review article
C2 - 38327757
AN - SCOPUS:85184915188
SN - 2666-2345
VL - 7
SP - 24
EP - 40
JO - Journal of Immunotherapy and Precision Oncology
JF - Journal of Immunotherapy and Precision Oncology
IS - 1
ER -