Novel drugs to ameliorate gastrointestinal normal tissue radiation toxicity in clinical practice:  what is emerging from the laboratory?
OBJECTIVE
To give an overview of promising novel agents under development for the prevention and reduction of gastrointestinal radiation injury.


RESULTS
Currently, several novel agents are being tested as drugs to prevent or reduce gastrointestinal radiation injury. These drugs may not only prevent injury, but also mitigate toxicity, that is, reduce injury after radiation exposure has occurred. Promising novel agents include the somatostatin analogue SOM230, growth factors, agents acting on the toll-like receptor 5 pathway, endothelial protectants, and the vitamin E analogue γ-tocotrienol.


CONCLUSIONS
Gastrointestinal radiation injury is the most important dose-limiting factor during radiotherapy of the abdomen or pelvis. It may severely affect the quality of life both during radiotherapy treatment and in cancer survivors. To date, there are no agents that can prevent or reduce intestinal radiation injury. Hence, there is an urgent need for the development of novel drugs to ameliorate intestinal toxicity during and after radiotherapy. This review summarizes the several agents that have been shown to reduce intestinal radiation injury in animals. Further research is needed to investigate their safety and efficacy in patients receiving radiotherapy for abdominal or pelvic tumours.
Department of Radiation Oncology (Maastro), GROW Research Institute, Maastricht University Medical Center, Maastricht, The Netherlands. maaike.berbee@maastro.nl
Maaike
M
Berbée
Martin
M
Hauer-Jensen
D002839:Chromans / Q000627:therapeutic use; D004727:Endothelium / Q000528:radiation effects; D041981:Gastrointestinal Tract / Q000528:radiation effects*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use; D009369:Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011837:Radiation-Protective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011878:Radiotherapy / Q000009:adverse effects*; D051198:Toll-Like Receptor 5 / Q000187:drug effects / Q000528:radiation effects; D014810:Vitamin E / Q000031:analogs & derivatives / Q000627:therapeutic use
D002839:Chromans; D036341:Intercellular Signaling Peptides and Proteins; D011837:Radiation-Protective Agents; D051198:Toll-Like Receptor 5; D014810:Vitamin E; C013649:plastochromanol 8