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Local analgesic effect of a bioadhesive barrier-forming oral liquid in cancer patients with oral mucositis caused by chemotherapy and/or radiotherapy: a randomized multicenter, single-use, positive-controlled, open-label study

Authors Cheng Y, Qin SK, Chen YP, Dong LH, Sun XD, Yu SY, Wu SK

Received 30 August 2018

Accepted for publication 31 October 2018

Published 30 November 2018 Volume 2018:11 Pages 8555—8564


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Takuya Aoki

Yuan Cheng,1 Shu Kui Qin,1 Yan Ping Chen,2 Li Hua Dong,3 Xiang Dong Sun,4 Shi Ying Yu,5 Shi Kai Wu6

1Department of Oncology, Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, China; 2Department of Stomatology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China; 3Department of Radiotherapy, First Hospital of Jilin University, Changchun 130021, China; 4Department of Radiotherapy, Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, China; 5Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430012, China; 6Department of Radiation Oncology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 10071, China

Objective: CAM2028 (Episil®; Camurus AB, Lund, Sweden) is a liquid for use in the oral cavity to treat various pains associated with mouth injuries. Upon contact with the swollen oral mucosa, the oral liquid forms a thin protective film that acts as a mechanical barrier to relieve pain. This study was the first in China to evaluate the local analgesic effect of oral liquid in cancer patients who developed oral mucositis following chemotherapy and/or radiotherapy.
Methods: A total of 60 patients were randomized in a 1:1 ratio to the CAM2028 group (the pump device was firmly pressed three times and the fluid was distributed to the painful area of the oral cavity) or KS (a mucoadhesive oral wound rinse, Kangsu™; Luye Pharmaceutical Co. Ltd, Nanjing, China) group (5 mL of the oral rinse was poured into and kept in the oral cavity for at least 1 minute). The primary endpoint was the area under the oral mucosal pain score–time curve (AUC) within 6 hours of treatment in the trial and control groups. Medical device adverse events were assessed according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events, version 4.0. Statistical analyses were performed using the chi-squared test (Fisher’s exact test), independent-samples t-test, and analysis of covariance.
Results: Sixty patients were included in the per-protocol set population analysis. The average (mean ± SD) 6-hour AUC of the CAM2028 group and the KS group was 14.20±10.29 and 24.46±14.15, respectively. The difference between the groups was statistically significant (P=0.0022). The incidence of adverse events in the trial group and the control group was 16.67% and 30.0%, respectively, and there was no statistical difference.
Conclusions: CAM2028 displayed an efficacious local analgesic effect in cancer patients who developed oral mucositis following chemotherapy and/or radiotherapy. The results demonstrated its potential value in clinical applications.

Keywords: oral mucositis, radiotherapy, chemotherapy, analgesic effect, episil

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