“Using genomics to identify or define patients at risk for oral mucositis is close to becoming a clinically actionable reality,” Sonis tells Oncology Nurse Advisor. “Identification of genes associated with drug metabolism has been available for some time and has focused on genes controlling the enzymes for mucotoxic agents [such as] 5-FU and methotrexate. And while genetic defects associated with drug metabolism are relatively rare, their identification and association with toxicity risk served as proof-of-concept.”

“Utilization of sophisticated analytics that recognize that genes are ‘team players’ has enabled genomic risk prediction for mucositis among patients receiving conditioning regimens prior to stem cell transplant and [patients] receiving conventional chemotherapy regimens,” Sonis adds. Toxicity risk prediction should also be applied to patients whose treatment plan includes radiation therapy, he explained.

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Oncology nurses bear the brunt of symptom prevention and management, Sonis notes. “They are generally the health care providers with the most contact with patients. Consequently, oncology nurses are often best placed to convey to patients the importance of oral health in the context of overall well-being and to teach, assess, and monitor all aspects of oral health during treatment. Importantly, by recognizing abnormalities in the clinical appearance of the mouth or in symptom complexes associated with it, oncology nurses can catalyze aggressive intervention to prevent small problems from becoming disasters.”

Bryant Furlow is a medical journalist based in Albuquerque, New Mexico.  


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