Emerging treatments
Topical therapies
Several different rinse or oral spray-based agents have been developed and marketed as medical devices.[51] These include supersaturated calcium/phosphate electrolyte rinses, and several topical coating agents that are intended to reduce pain by covering the oral ulcerations. None of these agents are recommended in the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology guidelines due to insufficient evidence.[22][45] Additional studies are ongoing. One study supports the prophylactic use of dexamethasone mouthwash for stomatitis secondary to everolimus.[52]
Probiotics
Cancer therapy-induced shifts in the oral microbiome may have a role in the development and severity of OM.[18] Probiotics may reduce the severity of mucositis by enhancing the immune response and modifying the microbiota. One randomised controlled trial in patients with nasopharyngeal carcinoma receiving concurrent radiochemotherapy found patients treated with a probiotic combination had significantly reduced OM severity; 45.7% of patients developed grade 3 OM in the placebo group, compared with 15.5% in the probiotic combination group.[53]
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