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Caphosol (EUSA Pharma) is a mouth rinse designed to moisten, lubricate and clean the oral cavity including the mucosa of the mouth, tongue and oropharynx which has been shown to prevent and treat oral mucositis in patients receiving radiation therapy or chemotherapy for the treatment of cancer.
There is a lack of good quality evidence for the efficacy of caphosol solution and the only systematic review is funded by the manufacturer and so carries an increased risk of bias. [1]
The safety and efficacy of Caphosol has been demonstrated in a double-blind prospective, randomized clinical trial in patients undergoing bone marrow transplantation. [2] This trial demonstrated that Caphosol, used in conjunction with fluoride treatments, offers significant benefits over standard care, and is a significant adjunct in the management of oral mucositis associated with high-dose chemotherapy and radiation therapy. In this study the duration and severity of oral mucositis, and requirements for opioid medication, were evaluated in 95 patients undergoing bone marrow transplantation. The treatment arm received 4 topical fluoride treatments plus Caphosol, while the control arm received a fluoride rinse (0.01% NaF aqueous solution). Patients were instructed to rinse 4 times per day at the start of cancer treatment and up to 10 times per day if they developed severe oral mucositis. The results showed:
Caphosol has also been associated with low occurrence and severity of oral mucositis in a registry of cancer patients. [3] The registry data provide further evidence to support the use of Caphosol to treat oral mucositis and suggest that Caphosol is associated with a low occurrence and severity of oral mucositis with high adherence to treatment as well as high levels of satisfaction from both patients and physicians.
The registry analysed the effects of Caphosol in head and neck cancer patients along with the frequency of patient dosing, adherence to treatment, and patient and physician global satisfaction assessments. Patients at risk of oral mucositis were given Caphosol, and instructed to rinse 4–10 times daily, depending on the severity of the mucositis. Patients and physicians completed questionnaires on the symptoms of oral mucositis, mucositis severity and satisfaction with the treatment.
The results showed that 88% of patients receiving chemotherapy and/or radiotherapy for head and neck cancer who had used Caphosol experienced no or low grade (mild-moderate) oral mucositis, and 44% experienced mild or no oral pain. Furthermore, the vast majority of head and neck cancer patients (79%) and physicians (78%) were satisfied with Caphosol as a treatment for mucositis.
A a prospective multicenter double-blind randomized controlled trial showed no advantages for caphosol, and statistically significantly more days of pain and analgesia use for the caphosol arm. [4]
According to the manufacturer, solution consists of: [5]
Mouthwash, mouth rinse, oral rinse, or mouth bath is a liquid which is held in the mouth passively or swirled around the mouth by contraction of the perioral muscles and/or movement of the head, and may be gargled, where the head is tilted back and the liquid bubbled at the back of the mouth.
Chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs as part of a standardized chemotherapy regimen. Chemotherapy may be given with a curative intent or it may aim to prolong life or to reduce symptoms. Chemotherapy is one of the major categories of the medical discipline specifically devoted to pharmacotherapy for cancer, which is called medical oncology.
A myelodysplastic syndrome (MDS) is one of a group of cancers in which immature blood cells in the bone marrow do not mature, and as a result, do not develop into healthy blood cells. Early on, no symptoms typically are seen. Later, symptoms may include fatigue, shortness of breath, bleeding disorders, anemia, or frequent infections. Some types may develop into acute myeloid leukemia.
Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood, in order to replicate inside a patient and produce additional normal blood cells. HSCT may be autologous, syngeneic, or allogeneic.
Fluoride therapy is the use of fluoride for medical purposes. Fluoride supplements are recommended to prevent tooth decay in children older than six months in areas where the drinking water is low in fluoride. It is typically used as a liquid, pill, or paste by mouth. Fluoride has also been used to treat a number of bone diseases.
Adjuvant therapy, also known as adjunct therapy, adjuvant care, or augmentation therapy, is a therapy that is given in addition to the primary or initial therapy to maximize its effectiveness. The surgeries and complex treatment regimens used in cancer therapy have led the term to be used mainly to describe adjuvant cancer treatments. An example of such adjuvant therapy is the additional treatment usually given after surgery where all detectable disease has been removed, but where there remains a statistical risk of relapse due to the presence of undetected disease. If known disease is left behind following surgery, then further treatment is not technically adjuvant.
Palifermin is a truncated human recombinant keratinocyte growth factor (KGF) produced in Escherichia coli. KGF stimulates the growth of cells that line the surface of the mouth and intestinal tract.
Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer. Mucositis can occur anywhere along the gastrointestinal (GI) tract, but oral mucositis refers to the particular inflammation and ulceration that occurs in the mouth. Oral mucositis is a common and often debilitating complication of cancer treatment.
Defibrotide, sold under the brand name Defitelio, is a mixture of single-stranded oligonucleotides that is purified from the intestinal mucosa of pigs. It is used to treat veno-occlusive disease of the liver of people having had a bone marrow transplant, with different limitations in the US and the European Union. It works by protecting the cells lining blood vessels in the liver and preventing blood clotting; the way it does this is not well understood.
Maribavir, sold under the brand name Livtencity, is an antiviral medication that is used to treat post-transplant cytomegalovirus (CMV). Maribavir is a cytomegalovirus pUL97 kinase inhibitor that works by preventing the activity of human cytomegalovirus enzyme pUL97, thus blocking virus replication.
Gelclair is a medicinal oral gel containing poly-vinyl-pyrrolidone (PVP) and hyaluronic acid that coats the surface of the mouth forming a thin protective film over painful oral lesions, such as those caused by radiotherapy or chemotherapy treatment for cancer.
Karen H. Antman is an American physician. She is the dean of Boston University School of Medicine and provost of the Boston University Medical Campus. Antman developed standards for the treatment of patients receiving chemotherapy including pharmacology, growth factors and mobilization of peripheral blood derived stem cells for blood and marrow transplant.
Nanobiotix is a biotechnology company that uses nanomedicine to develop new radiotherapy techniques for cancer patients. The company is headquartered in Paris, with additional corporate offices in New York and Massachusetts.
Chemotherapy-induced peripheral neuropathy (CIPN) is a nerve-damaging side effect of antineoplastic agents in the common cancer treatment, chemotherapy. CIPN afflicts between 30% and 40% of patients undergoing chemotherapy. Antineoplastic agents in chemotherapy are designed to eliminate rapidly dividing cancer cells, but they can also damage healthy structures, including the peripheral nervous system. CIPN involves various symptoms such as tingling, pain, and numbness in the hands and feet. These symptoms can impair activities of daily living, such as typing or dressing, reduce balance, and increase risk of falls and hospitalizations. They can also give cause to reduce or discontinue chemotherapy. Researchers have conducted clinical trials and studies to uncover the various symptoms, causes, pathogenesis, diagnoses, risk factors, and treatments of CIPN.
High-dose chemotherapy and bone marrow transplant (HDC/BMT), also high-dose chemotherapy with autologous bone marrow transplant, was an ineffective treatment regimen for metastatic breast cancer, and later high-risk breast cancer, that was considered promising during the 1980s and 1990s. With an overall idea that more is better, this process involved taking cells from the person's bone marrow to store in a lab, then to give such high doses of chemotherapy drugs that the remaining bone marrow was destroyed, and then to inject the cells taken earlier back into the body as replacement. It was ultimately determined to be no more effective than normal treatment, and to have significantly higher side effects, including treatment-related death.
Elacestrant, sold under the brand name Orserdu, is an anticancer medication which is used in the treatment of breast cancer. It is taken by mouth.
Erdafitinib, sold under the brand name Balversa, is an anti-cancer medication. It is a small molecule inhibitor of fibroblast growth factor receptor (FGFR) used for the treatment of cancer. FGFRs are a subset of tyrosine kinases which are unregulated in some tumors and influence tumor cell differentiation, proliferation, angiogenesis, and cell survival. Astex Pharmaceuticals discovered the drug and licensed it to Janssen Pharmaceuticals for further development.
Lisocabtagene maraleucel, sold under the brand name Breyanzi, is a cell-based gene therapy used to treat B-cell lymphoma and follicular lymphoma.
G1 Therapeutics, Inc. is an American biopharmaceutical company headquartered in Research Triangle Park, North Carolina. The company specializes in developing and commercializing small molecule therapeutics for the treatment of patients with cancer.
High-dose chemotherapy (HDC) is referring to chemotherapy medicines which are given at larger dosages than that are usually used in normal chemotherapy regimens. This therapeutic strategy is used to treat some cancers, especially those that are aggressive or have a high chance of coming back. With increased doses of chemotherapy chemicals administered to the body, HDC seeks to optimize the death of cancer cells.