Prevention and treatment options for mTOR inhibitor-associated stomatitis

  title={Prevention and treatment options for mTOR inhibitor-associated stomatitis},
  author={Kelly Staves and K. Ramchandran},
  journal={The Journal of community and supportive oncology},
Mammalian target of rapamycin (mTOR), a serine–threonine protein kinase, operates in the phosphoinositide 3-kinase (PI3K)–protein kinase B (AKT)–mTOR signal transduction pathway regulating both normal and cancer cellular processes, including cell growth, proliferation, motility, survival, and protein and lipid synthesis.1 Genetic alterations affecting this pathway, including mutations in receptor tyrosine kinases PI3K and AKT, occur frequently in human cancers,2 supporting the rationale to… Expand
Everolimus-based combination therapies for HR+, HER2- metastatic breast cancer.
Key data on everolimus-based combinations focusing on efficacy, safety, biomarkers, quality of life, and health economic outcomes are summarized in the context of the changing MBC treatment algorithm. Expand
Prevention of Stomatitis
Recommendations are provided for oncology nurses to educate patients on prevention, early detection, monitoring, and management strategies to mitigate the incidence and severity of everolimus‐related stomatitis. Expand


The phosphoinositide-3-kinase-Akt-mTOR pathway as a therapeutic target in breast cancer.
The role of the PI3-kinase-Akt-mTOR pathway in breast cancer biology and the clinical trial evidence available to date are reviewed. Expand
PI3K and cancer: lessons, challenges and opportunities
Through a greater focus on patient selection, increased understanding of immune modulation and strategic application of rational combinations, it should be possible to realize the potential of this promising class of targeted anticancer agents. Expand
Dosing and Safety Implications for Oncologists When Administering Everolimus to Patients With Hormone Receptor-Positive Breast Cancer.
  • H. Rugo
  • Medicine
  • Clinical breast cancer
  • 2016
Assessment of data from the Breast Cancer Trials of Oral Everolimus 2 trial have shown that, despite a greater frequency of AEs in the everolimus plus exemestane treatment arm, the AEs were effectively managed with temporary dose reductions or interruptions, suggesting that appropriate dose reductions for toxicity will not adversely impact efficacy. Expand
Managing stomatitis in patients treated with Mammalian target of rapamycin inhibitors.
The severity of mIAS can be minimized by following common preventive steps and initiating treatment at the first sign of mouth discomfort, thereby reducing the likelihood of treatment discontinuation. Expand
Incidence and Risk of High-grade Stomatitis with mTOR Inhibitors in Cancer Patients
The mTOR inhibitors everolimus and temsirolimus significantly increased the risk of high-grade stomatitis in cancer patients and efforts towards the prevention, treatment, and identification of individuals at risk may allow for improved quality of life and consistent dosing. Expand
Clinical presentation and management of mTOR inhibitor-associated stomatitis.
It is demonstrated that local and systemic corticosteroid therapy is an effective approach to managing patients with symptomatic mIAS, a common and potentially dose limiting toxicity associated with the use of mTOR inhibitors in cancer treatment. Expand
A review of oral toxicity associated with mTOR inhibitor therapy in cancer patients.
Oral mucositis is a frequent complication of mTOR inhibitor therapy and a significant cause of dose reductions and discontinuations in oncology trials and prevention and management strategies should be investigated to improve tolerability and better permit effective long-term regimens. Expand
MicroRNA-99 Family Targets AKT/mTOR Signaling Pathway in Dermal Wound Healing
Evidence that miR-99 family members contribute to wound healing by regulating the AKT/mTOR signaling is provided. Expand
Preliminary characterization of oral lesions associated with inhibitors of mammalian target of rapamycin in cancer patients
An analysis of the appearance, course, and toxicity associations of mTOR inhibitor‐associated stomatitis (mIAS) demonstrated that the condition is distinct from conventional mucositis (CM) and more closely resembles aphthous stom atitis. Expand
Phase I pharmacokinetic and pharmacodynamic study of the oral mammalian target of rapamycin inhibitor everolimus in patients with advanced solid tumors.
  • A. O'Donnell, S. Faivre, +11 authors I. Judson
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2008
Everolimus was satisfactorily tolerated at dosages up to 70 mg/wk and 10 mg/d with predictable PK and Antitumor activity and PD in tumors require further clinical investigation. Expand