Source: professional.cancerconsultants.com
Author: staff

Researchers from Korea have reported that recombinant epidermal growth factor (EGF) delivered as a spray twice daily may decrease the severity of severe mucositis in patients undergoing radiotherapy with or without chemotherapy for head and neck cancer. The details of this study appeared in an early online publication on June 9, 2009 in Cancer.[1]

Oral mucositis is a frequent clinical problem in patients receiving chemotherapy and/or radiation therapy. Mucositis can be a severe dose-limiting toxicity, especially in patients receiving high-dose chemotherapy.

Keritonocyte growth factor (Kepivance®) has been approved for prevention of mucositis in patients undergoing autologous stem cell transplantation. Other methods of treating or preventing oral mucositis include oral antiseptics, cryotherapy, laser therapy, L-glutamine (Saforis® and velafermin). Previous studies of antiseptic, antibiotic, and antifungal mouth washes and lozenges have revealed no dramatic effects, but two recent randomized trials suggested a limited role for topical antibiotic and antifungal treatment of mucositis.

This multicenter trial enrolled 113 patients who were receiving definitive chemoradiotherapy or adjuvant radiotherapy. Patients were randomly allocated to a placebo group or to a group receiving three doses of EGF. Responders were defined as patients who had an RTOG grade of 2 or lower at the fourth- and fifth-week examinations. By this criteria 64% of patients receiving a 50-microgram dose of EGF responded compared with 37% in the control group. These authors concluded: “The EGF spray may have potential benefit for oral mucositis in patients undergoing RT for head and neck cancer. Phase 3 studies are ongoing to confirm this.”

Comments: Epidermal growth factor can now be added to the list of potential preventives and treatments for oral mudositis. Randomized control trials will include data on recurrence to make sure EGF does not stimulate tumor growth.

Reference:
[1] Gyun H, Song SY, Kim YS, et al. Therapeutic effect of recombinant human epidermal growth factor (rhEGF) on mucositis in patients undergoing radiotherapy, with or without chemotherapy, for head and neck cancer. Cancer. 2009.