Immune checkpoint inhibitors in cancer therapy: Review of orofacial adverse events and role of the oral healthcare provider

Brittany A Klein; Muhammad Ali Shazib; Alessandro Villa; Fábio de Abreu Alves; Piamkamon Vacharotayangul; Stephen Sonis; Stefano Fedele; Nathaniel S Treister

doi:10.3389/froh.2022.968157

Immune checkpoint inhibitors in cancer therapy: Review of orofacial adverse events and role of the oral healthcare provider

Front Oral Health. 2022 Aug 11:3:968157. doi: 10.3389/froh.2022.968157. eCollection 2022.

Authors

Brittany A Klein^{1

2}, Muhammad Ali Shazib³, Alessandro Villa⁴, Fábio de Abreu Alves^{5

6}, Piamkamon Vacharotayangul^{1

2}, Stephen Sonis^{1

2}, Stefano Fedele^{7

8}, Nathaniel S Treister^{1

2}

Affiliations

¹ Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, United States.
² Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.
³ Division of Surgical and Specialty Care, Workman School of Dental Medicine, High Point University, High Point, NC, United States.
⁴ Department of Orofacial Science, University of California San Francisco School of Dentistry, San Francisco, CA, United States.
⁵ A.C. Camargo Cancer Center, São Paulo, Brazil.
⁶ University of São Paulo School of Dentistry, São Paulo, Brazil.
⁷ Department of Clinical Research, Eastman Dental Institute, University College London, London, United Kingdom.
⁸ National Institute for Health and Care Research (NIHR) University College London Hospitals Biomedical Research Center, London, United Kingdom.

Abstract

Immune checkpoint inhibitors (ICIs) are a revolutionary class of antineoplastic therapy that restore anti-tumor immunity. Consequences of this enhanced immune response include a multitude of immune related adverse events (irAEs) that can affect any body system, including the mouth. Orofacial irAEs reproduce features of numerous immune-mediated conditions, including oral lichen planus, mucous membrane pemphigoid, and Sjögren syndrome, among others. The aim of this review is to summarize known orofacial irAEs and to familiarize oral healthcare providers with how to identify and manage these toxicities as part of the care team for patients treated with ICIs.

Keywords: cancer; immunotherapy; oral medicine; oral pathology; toxicity.

Publication types

Review