Supportive Care in Cancer

, Volume 21, Issue 7, pp 2075–2083 | Cite as

Emerging evidence on the pathobiology of mucositis

  • Noor Al-DasooqiEmail author
  • Stephen T. Sonis
  • Joanne M. Bowen
  • Emma Bateman
  • Nicole Blijlevens
  • Rachel J. Gibson
  • Richard M. Logan
  • Raj G. Nair
  • Andrea M. Stringer
  • Roger Yazbeck
  • Sharon Elad
  • Rajesh V. Lalla
  • For The Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)
Review Article



Considerable progress has been made in our understanding of the biological basis for cancer therapy-induced mucosal barrier injury (mucositis). The last formal review of the subject by MASCC/ISOO was published in 2007; consequently, an update is timely.


Panel members reviewed the biomedical literature on mucositis pathobiology published between January 2005 and December 2011.


Recent research has provided data on the contribution of tissue structure changes, inflammation and microbiome changes to the development of mucositis. Additional research has focused on targeted therapy-induced toxicity, toxicity clustering and the investigation of genetic polymorphisms in toxicity prediction. This review paper summarizes the recent evidence on these aspects of mucositis pathobiology.


The ultimate goal of mucositis researchers is to identify the most appropriate targets for therapeutic interventions and to be able to predict toxicity risk and personalize interventions to genetically suitable patients. Continuing research efforts are needed to further our understanding of mucositis pathobiology and the pharmacogenomics of toxicity.


Mucosal injury Cancer therapy Targeted drugs Toxicity Alimentary tract Pharmacogenetics 


Conflict of interest

This project was carried out as part of the MASCC/ISOO Mucositis Guidelines Update, which was supported by BioAlliance Pharma and Helsinn Healthcare, NA. No industry representatives participated in the development of this manuscript in any way.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Noor Al-Dasooqi
    • 1
    Email author
  • Stephen T. Sonis
    • 2
  • Joanne M. Bowen
    • 3
  • Emma Bateman
    • 1
  • Nicole Blijlevens
    • 4
  • Rachel J. Gibson
    • 5
  • Richard M. Logan
    • 6
  • Raj G. Nair
    • 7
  • Andrea M. Stringer
    • 8
  • Roger Yazbeck
    • 8
  • Sharon Elad
    • 9
  • Rajesh V. Lalla
    • 10
  • For The Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)
  1. 1.Discipline of MedicineUniversity of AdelaideAdelaideUSA
  2. 2.Brigham and Women’s HospitalDana-Farber Cancer InstituteBostonUSA
  3. 3.Discipline of PhysiologyUniversity of AdelaideAdelaideUSA
  4. 4.Department of HaematologyUniversity Medical Center NijmegenNijmegenThe Netherlands
  5. 5.Discipline of Anatomy and PathologyUniversity of AdelaideAdelaideUSA
  6. 6.School of DentistryUniversity of AdelaideAdelaideUSA
  7. 7.Discipline of Oral MedicineGriffith University and Department of Haematology and Oncology, Queensland HealthGold CoastAustralia
  8. 8.School of Pharmacy and Medical SciencesUniversity of South AustraliaAdelaideAustralia
  9. 9.Division of Oral Medicine, Eastman Institute for Oral HealthUniversity of Rochester Medical CenterRochesterUSA
  10. 10.Section of Oral Medicine and Neag Comprehensive Cancer CenterUniversity of Connecticut Health CenterFarmingtonUSA

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