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Usefulness of Dexamethasone Ointment for Preventing Everolimus-induced Stomatitis

Everolimus (ERL) is the first oral molecular targeted drug in the therapeutic area of breast cancer, inducing a wide range of side effects. Stomatitis occurs at high frequency in treatment with ERL. Stomatitis at Grade 2 and above not only deteriorates the quality of life but also leads to withdrawal of ERL. We administered azulene gargle to prevent stomatitis, but 3 out of 9 cases suffered stomatitis at Grade 2 and above. Therefore, we introduced a method of applying dexamethasone ointment (DEX) until recovery as a preventive measure for stomatitis at Grade 2 and above at the time in which stomatitis at Grade 1 occurred, and then examined the usefulness of such method. In this method, electronic medical records were examined retrospectively with respect to 35 breast cancer patients treated with ERL in our hospital from April 2014 to February 2018. Eleven cases had no administration of DEX for the treatment of stomatitis at Grade 1 (non-DEX group). Seven cases had the onset of stomatitis at Grade 2 and above with an incidence rate of 63.6%. Twentyfour cases had an application of DEX (DEX group). One case had an onset of stomatitis at Grade 2 and above with an incidence rate of 4.2%. Stomatitis at Grade 2 and above could be significantly reduced in the DEX group (P < 0.05). This examination suggests the usefulness of treatment of stomatitis at Grade 1 with DEX for the prevention of ERLinduced stomatitis at Grade 2 and above.