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Review| Volume 86, P125-134, November 2017

Insight in taste alterations during treatment with protein kinase inhibitors

  • Author Footnotes
    1 These authors contributed equally.
    A. van der Werf
    Footnotes
    1 These authors contributed equally.
    Affiliations
    Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands

    Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands
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  • Author Footnotes
    1 These authors contributed equally.
    M. Rovithi
    Footnotes
    1 These authors contributed equally.
    Affiliations
    Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands

    Medical Oncology Unit, Department of Internal Medicine, Agios Nikolaos General Hospital, Const. Paleologos & Knossos, PC 72100, Agios Nikolaos, Crete, Greece
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  • J.A.E. Langius
    Affiliations
    Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands

    Department of Nutrition and Dietetics, Faculty of Health, Nutrition and Sport, The Hague University of Applied Sciences, P.O. Box 13336, 2501 EH, The Hague, The Netherlands
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  • M.A.E. de van der Schueren
    Affiliations
    Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands

    Faculty of Health and Social Studies, Department of Nutrition and Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands
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  • H.M.W. Verheul
    Correspondence
    Corresponding author.
    Affiliations
    Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally.
Published:October 04, 2017DOI:https://doi.org/10.1016/j.ejca.2017.09.006

      Highlights

      • Patient-reported taste alterations are a commonly reported side-effect of protein kinase inhibitors (PKIs).
      • The underlying pathobiology is unknown and it has never been established whether an objective taste dysfunction develops.
      • Hypothesized mechanisms include oral toxicity and altered taste or smell perception.
      • These factors should objectively be assessed to unravel the pathobiology, needed for development of potential treatment options.

      Abstract

      The role of Protein Kinase Inhibitors (PKI) in the treatment of various types of cancer is increasingly prominent. Their clinical application is accompanied by the development of side effects, among which patient-reported taste alterations. These alterations are missed frequently, but impair nutritional intake, are associated with weight loss and often result in significant morbidity, especially in the context of chronic administration. Accurate reporting of taste alterations is hampered by lack of modules for symptom objectification and inadequate understanding on the underlying mechanisms. In this review we initially describe the physiology of taste and smell and the mechanism of action of PKIs. We proceed to summarize taste related side effects as reported in major clinical trials and describe possible causal factors. Lastly, an in-depth analysis is given on potential molecular pathways responsible for the PKI-induced taste alterations. Objectification of patient-reported symptoms and universal reporting, along with a better understanding of the underlying mechanisms, will lead to early recognition and optimized treatment, ultimately improving patient adherence and quality of life.

      Keywords

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