title: Oral ulcers in patients with advanced breast cancer receiving everolimus: a case series report on clinical presentation and management.
abstract: OBJECTIVE
  We report the clinical features and management outcomes in 7 patients with everolimus-related stomatitis.
  
  
  METHODS
  Fifteen women with hormone-receptor-positive advanced breast cancer receiving everolimus combined with exemestane were prospectively evaluated to assess the development of stomatitis. Oral ulcers were diagnosed based on established criteria.
  
  
  RESULTS
  Seven patients developed stomatitis (46.6%). All patients were treated with topical dexamethasone solution, while everolimus was temporarily discontinued in 4 patients. Stomatitis resolved within 1-2 weeks. Two of the 4 patients, who had interrupted everolimus, developed recurrent stomatitis following drug resume and everolimus was again discontinued and restarted after 2 weeks. To date, 5 patients receive everolimus in full dose. The 2 patients, who developed recurrent stomatitis, received a reduced dose.
  
  
  CONCLUSIONS
  Everolimus-related oral ulcers were frequent and led to dose modifications. Controlled trials, endorsing a consensus in terminology, are needed to evaluate measures on prevention and management of this unique toxicity.
authors: Clinic of Hospital Dentistry, Oral Oncology Unit, Dental School, University of Athens, Athens, Greece. nicolatou.galitis@hotmail.com
authors: Ourania
authors: O
authors: Nicolatou-Galitis
authors: Adamantia
authors: A
authors: Nikolaidi
authors: Ilias
authors: I
authors: Athanassiadis
authors: Erofili
authors: E
authors: Papadopoulou
authors: Stephen
authors: S
authors: Sonis
mesh_terms: D000368:Aged; D000730:Androstadienes / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D002277:Carcinoma / Q000188:drug therapy / Q000556:secondary; D003907:Dexamethasone / Q000627:therapeutic use; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D019226:Oral Ulcer / Q000139:chemically induced* / Q000188:drug therapy; D011446:Prospective Studies; D012008:Recurrence; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013280:Stomatitis / Q000139:chemically induced* / Q000188:drug therapy; D013281:Stomatitis, Aphthous / Q000139:chemically induced / Q000188:drug therapy; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
chemical_list: D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D000068338:Everolimus; D058570:TOR Serine-Threonine Kinases; C056516:exemestane; D020123:Sirolimus