Pharmacotherapy of Oral Mucositis with Palifermin

Oral mucositis (OM) is one of the most debilitating and common side effects of intensive anti-cancer treatment. OM is associated with adverse clinical and economic outcomes. In addition to its symptomatic impact, OM increases the likelihood of unplanned breaks or delays in anti-cancer treatment, reduction in dose of chemotherapy, use of feeding tube placement or total parenteral nutrition, the need for an intravenous line, opioid use and hospitalization. Palifermin is a N-truncated recombinant human keratinocyte growth factor (KGF), a member of the fibroblast growth factor (FGF) family, which binds specifically to the human KGF receptor and induces proliferation and differentiation of epithelial cells, including gastrointestinal epithelial cells, hepatocytes, type II pneumocytes, and transitional urothelial cells. It is the first agent approved by the U.S Food and Drug Administration and other regulatory authorities around the world for use in the prevention of oral mucositis caused by high-dose chemotherapy and stem cell transplantation. The following review aims to cover the recent peer-reviewed literature pertaining to the role of palifermin in the prevention of OM in different groups of patients treated with radiation therapy or chemotherapy against cancers.