Oral Mucositis
Oral mucositis is the (painful) inflammation, necrosis and ulceration of the mucosa along the gastrointestinal tract, affecting nearly every patient that receives radiotherapy of the head/neck region or bone marrow transplant. Cardinal symptoms include ulcerations, debilitating pain and inability to eat and/or sustain anti-cancer therapy. Ulcers can reach a diameter of 4 cm and oral mucositis can be severely painful, resulting in speaking and eating difficulties or even trouble opening the mouth. Approximately 50% of chemotherapy patients develop such severe mucositis that the patient's anti-cancer treatment must be tempered.
Etiology
The oral cavity is lined with rapidly dividing epithelial cells, which can be an unintended target for anti-cancer treatment. Oral mucositis results from injury to these cells, as a consequence of chemo- and/or radiotherapy targeting rapidly dividing cancer cells. Cell death in the epithelial layer leads to subsequent thinning of the mucosal lining and the patient’s mouth becomes red, inflamed and ulcerated. Patients usually start experiencing symptoms shortly after the onset of the anti-cancer treatment.
Standard Care
Treatment of mucositis is symptomatic and mainly focused on oral hygiene. Saltwater, chlorhexidine or analgesic mouthwash can temporarily alleviate some of the symptoms. Dietary changes have to be considered and in some cases even non-oral dietary supplementation. Several biological drugs exist for the treatment of oral mucositis, for example, recombinant epithelial growth factors. When standard care is insufficient, these more experimental therapies can be considered, albeit only in selected cases.
ActoGeniX’s Solution
ActoGeniX is developing ActoBiotic™ AG013 for the local delivery of epithelial healing factors into the oral cavity.