{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T21:15:55Z","timestamp":1783718155835,"version":"3.55.0"},"reference-count":124,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Tyrosine kinase inhibitors (TKIs), either as single agents or in combination with other drugs, have become a gold standard in many oncological pathologies. The identification, analysis, and clinical management of their multiple and various systemic adverse events are a clear requirement and represent a true challenge in daily practice. For this narrative review, registration clinical trials that have led to the approval of certain TKI protocols in the setting of renal cell carcinoma (RCC) were identified via the latest version of the National Comprehensive Cancer Network (NCCN) kidney cancer guidelines. The following keywords were used: Axitinib, Cabozantinib, Lenvatinib, Pazopanib, Sorafenib, Sunitinib, and Tivozanib. RCC therapies have been proven to frequently induce oral symptoms and pathologies such as stomatitis, dysgeusia, xerostomia, osteonecrosis of the jaws, oral dysesthesia, geographic tongue, and dental and periodontal damage. The aim of this review is to emphasize the mechanisms of these common drug-induced buccodental toxicities associated with TKI therapies in RCC and to draft a general clinical management of these adverse events, in order to improve patients\u2019 quality of life and treatment adherence.<\/jats:p>","DOI":"10.3390\/dj13100439","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T12:15:31Z","timestamp":1758716131000},"page":"439","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Buccodental Toxicities Induced by Tyrosine Kinase Inhibitors in Patients Diagnosed with Renal Cell Carcinoma\u2014A Literature Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Adina","family":"Neme\u0219","sequence":"first","affiliation":[{"name":"Medical Oncology Department, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Medical Oncology Department, Prof. Dr. Ioan Chiricuta Oncology Institute, 400015 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Voskuil-Galos","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Medical Oncology Department, Prof. Dr. Ioan Chiricuta Oncology Institute, 400015 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1295-566X","authenticated-orcid":false,"given":"Olimpia","family":"Bunta","sequence":"additional","affiliation":[{"name":"Orthodontics Department, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1038\/s41392-023-01469-6","article-title":"Adverse effects of tyrosine kinase inhibitors in cancer therapy: Pathophysiology, mechanisms and clinical management","volume":"8","author":"Sharma","year":"2023","journal-title":"Signal. Transduct. Target Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.ecl.2008.03.001","article-title":"Management of medullary thyroid carcinoma","volume":"37","author":"Hu","year":"2008","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.7150\/ijms.1.101","article-title":"Tyrosine kinase\u2014Role and significance in Cancer","volume":"1","author":"Paul","year":"2004","journal-title":"Int. J. Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12943-018-0782-4","article-title":"Mechanisms of receptor tyrosine kinase activation in cancer","volume":"17","author":"Du","year":"2018","journal-title":"Mol. Cancer"},{"key":"ref_5","unstructured":"Thomson, R.J., Moshirfar, M., and Ronquillo, Y. (2025). Tyrosine Kinase Inhibitors. StatPearls, StatPearls Publishing. Internet."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"106552","DOI":"10.1016\/j.phrs.2022.106552","article-title":"Properties of FDA-approved small molecule protein kinase inhibitors: A 2023 update","volume":"187","author":"Roskoski","year":"2023","journal-title":"Pharmacol. Res."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Piciu, A., and Neme\u015f, A. (2024). Evaluation of prognostic factors for late recurrence in clear cell renal carcinoma: An institutional study. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1446953"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.juro.2011.09.028","article-title":"Population based analysis of the increasing incidence of kidney cancer in the United States: Evaluation of age specific trends from 1975 to 2006","volume":"187","author":"Nepple","year":"2012","journal-title":"J. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"11795549241285390","DOI":"10.1177\/11795549241285390","article-title":"Early-Stage Renal Cell Carcinoma Locoregional Therapies: Current Approaches and Future Directions","volume":"18","author":"Khandpur","year":"2024","journal-title":"Clin. Med. Insights Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Vergho, D.C., Loeser, A., Kocot, A., Spahn, M., and Riedmiller, H. (2012). Tumor thrombus of inferior vena cava in patients with renal cell carcinoma\u2014Clinical and oncological outcome of 50 patients after surgery. BMC Res. Notes, 5.","DOI":"10.1186\/1756-0500-5-264"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.euros.2023.04.015","article-title":"The Metastatic Risk of Renal Cell Carcinoma by Primary Tumor Size and Subtype","volume":"52","author":"Monda","year":"2023","journal-title":"Eur. Urol. Open Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.semnephrol.2019.12.004","article-title":"The Therapeutic Landscape of Renal Cell Carcinoma: From the Dark Age to the Golden Age","volume":"40","author":"Huang","year":"2020","journal-title":"Semin. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2859","DOI":"10.1200\/JCO.1999.17.9.2859","article-title":"Prospective randomized trial of interferon alfa-2a plus vinblastine versus vinblastine alone in patients with advanced renal cell cancer","volume":"17","author":"Salminen","year":"1999","journal-title":"J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1200\/JCO.2000.18.9.1928","article-title":"Effect of cytokine therapy on survival for patients with advanced renal cell carcinoma","volume":"18","author":"Motzer","year":"2000","journal-title":"J. Clin. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1177\/145749690409300212","article-title":"Systemic therapy in metastatic renal cell carcinoma","volume":"93","year":"2004","journal-title":"Scand. J. Surg."},{"key":"ref_16","first-page":"1","article-title":"On the Shoulders of Giants: The Evolution of Renal Cell Carcinoma Treatment-Cytokines, Targeted Therapy, and Immunotherapy","volume":"40","author":"Dutcher","year":"2020","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Comandone, A., Vana, F., Comandone, T., and Tucci, M. (2021). Antiangiogenic Therapy in Clear Cell Renal Carcinoma (CCRC): Pharmacological Basis and Clinical Results. Cancers, 13.","DOI":"10.3390\/cancers13235896"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Michaelis, J., Grabbert, M., Sigle, A., Yilmaz, M., Schlager, D., Gratzke, C., Miernik, A., and Schoeb, D.S. (2022). Tyrosine Kinase Inhibitors in the Treatment of Metastasised Renal Cell Carcinoma-Future or the Past?. Cancers, 14.","DOI":"10.3390\/cancers14153777"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1634\/theoncologist.2014-0177","article-title":"The European Medicines Agency approval of axitinib (Inlyta) for the treatment of advanced renal cell carcinoma after failure of prior treatment with sunitinib or a cytokine: Summary of the scientific assessment of the committee for medicinal products for human use","volume":"20","author":"Tzogani","year":"2015","journal-title":"Oncologist"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.euros.2021.12.007","article-title":"Efficacy and Safety of First-line Systemic Therapy for Metastatic Renal Cell Carcinoma: A Systematic Review and Network Meta-analysis","volume":"37","author":"Bosma","year":"2022","journal-title":"Eur. Urol. Open Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1177\/1756287217748867","article-title":"Cabozantinib in the treatment of advanced renal cell carcinoma in adults following prior vascular endothelial growth factor targeted therapy: Clinical trial evidence and experience","volume":"10","author":"Osanto","year":"2018","journal-title":"Ther. Adv. Urol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/CCO.0000000000000939","article-title":"Two is company, is three a crowd? Triplet therapy, novel molecular targets, and updates on the management of advanced renal cell carcinoma","volume":"35","author":"Goodstein","year":"2023","journal-title":"Curr. Opin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/978-3-319-91442-8_13","article-title":"Lenvantinib: A Tyrosine Kinase Inhibitor of VEGFR 1-3, FGFR 1-4, PDGFR\u03b1, KIT and RET","volume":"211","year":"2018","journal-title":"Recent Results Cancer Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1056\/NEJMoa2035716","article-title":"Lenvatinib plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma","volume":"384","author":"Motzer","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1016\/j.ejca.2012.12.010","article-title":"A randomised, double-blind phase III study of pazopanib in patients with advanced and\/or metastatic renal cell carcinoma: Final overall survival results and safety update","volume":"49","author":"Sternberg","year":"2013","journal-title":"Eur. J. Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/S0076-6879(05)07047-3","article-title":"Sorafenib (BAY 43-9006, Nexavar), a dual-action inhibitor that targets RAF\/MEK\/ERK pathway in tumor cells and tyrosine kinases VEGFR\/PDGFR in tumor vasculature","volume":"407","author":"Adnane","year":"2006","journal-title":"Methods Enzymol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1177\/1756287216663979","article-title":"Sunitinib in the treatment of metastatic renal cell carcinoma","volume":"8","author":"Schmid","year":"2016","journal-title":"Ther. Adv. Urol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1158\/1078-0432.CCR-21-2334","article-title":"FDA Approval Summary: Tivozanib for Relapsed or Refractory Renal Cell Carcinoma","volume":"28","author":"Chang","year":"2022","journal-title":"Clin. Cancer Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.hfc.2022.02.003","article-title":"Intracellular Signaling Pathways Mediating Tyrosine Kinase Inhibitor Cardiotoxicity","volume":"18","author":"Scott","year":"2022","journal-title":"Heart Fail. Clin."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1038\/sj.bjc.6603813","article-title":"Mechanisms of adverse effects of anti-VEGF therapy for cancer","volume":"96","author":"Kamba","year":"2007","journal-title":"Br. J. Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3293","DOI":"10.2147\/CMAR.S237968","article-title":"Tyrosine Kinase Inhibitor-Related Hepatotoxicity in Patients with Advanced Lung Adenocarcinoma: A Real-World Retrospective Study","volume":"12","author":"Qian","year":"2020","journal-title":"Cancer Manag. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"623","DOI":"10.2169\/internalmedicine.55.5712","article-title":"Sorafenib-induced Acute Pancreatitis: A Case Report and Review of the Literature","volume":"55","author":"Chou","year":"2016","journal-title":"Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2324709620936808","DOI":"10.1177\/2324709620936808","article-title":"Tyrosine Kinase Inhibitors\u2019 Newly Reported Endocrine Side Effect: Pazopanib-Induced Primary Adrenal Insufficiency in a Patient With Metastatic Renal Cell Cancer","volume":"8","author":"Elshimy","year":"2020","journal-title":"J. Investig. Med. High Impact. Case Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"865","DOI":"10.3892\/ol.2012.872","article-title":"Molecular mechanisms of lung-specific toxicity induced by epidermal growth factor receptor tyrosine kinase inhibitors","volume":"4","author":"Sakao","year":"2012","journal-title":"Oncol. Lett."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Xiong, Y., Wang, Q., Liu, Y., Wei, J., and Chen, X. (2022). Renal adverse reactions of tyrosine kinase inhibitors in the treatment of tumours: A Bayesian network meta-analysis. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.1023660"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"985780","DOI":"10.4061\/2011\/985780","article-title":"Challenges associated with tyrosine kinase inhibitor therapy for metastatic thyroid cancer","volume":"2011","author":"Cabanillas","year":"2011","journal-title":"J. Thyroid Res."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mugiya, T., Mothibe, M., Khathi, A., Ngubane, P., and Sibiya, N. (2024). Glycaemic abnormalities induced by small molecule tryosine kinase inhibitors: A review. Front. Pharmacol., 15.","DOI":"10.3389\/fphar.2024.1355171"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Verzicco, I., Regolisti, G., Quaini, F., Bocchi, P., Brusasco, I., Ferrari, M., Passeri, G., Cannone, V., Coghi, P., and Fiaccadori, E. (2020). Electrolyte Disorders Induced by Antineoplastic Drugs. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.00779"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Villa, A., and Kuten-Shorrer, M. (2023). Pathogenesis of Oral Toxicities Associated with Targeted Therapy and Immunotherapy. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24098188"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/j.oraloncology.2015.09.003","article-title":"Oral adverse events in cancer patients treated with VEGFR-directed multitargeted tyrosine kinase inhibitors","volume":"51","author":"Yuan","year":"2015","journal-title":"Oral Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1038\/bjc.2013.516","article-title":"Buccodental side effects of sunitinib in patients with metastatic renal cell carcinoma","volume":"109","author":"Gilabert","year":"2013","journal-title":"Br. J. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1634\/theoncologist.2011-0111","article-title":"Oral adverse events associated with tyrosine kinase and mammalian target of rapamycin inhibitors in renal cell carcinoma: A structured literature review","volume":"17","author":"Epstein","year":"2012","journal-title":"Oncologist"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12955-024-02227-0","article-title":"Health-related quality of life and its determinants among cancer patients: Evidence from 12,148 patients of Indian database","volume":"22","author":"Dixit","year":"2024","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/S1470-2045(13)70093-7","article-title":"Axitinib versus sorafenib as second-line treatment for advanced renal cell carcinoma: Overall survival analysis and updated results from a randomised phase 3 trial","volume":"14","author":"Motzer","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1056\/NEJMoa1816047","article-title":"Avelumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma","volume":"380","author":"Motzer","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1056\/NEJMoa1816714","article-title":"Pembrolizumab plus Axitinib versus Sunitinib for Advanced Renal-Cell Carcinoma","volume":"380","author":"Rini","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1200\/JCO.2016.70.7398","article-title":"Cabozantinib Versus Sunitinib As Initial Targeted Therapy for Patients With Metastatic Renal Cell Carcinoma of Poor or Intermediate Risk: The Alliance A031203 CABOSUN Trial","volume":"35","author":"Choueiri","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1056\/NEJMoa1510016","article-title":"Cabozantinib versus Everolimus in Advanced Renal-Cell Carcinoma","volume":"373","author":"Choueiri","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/S0140-6736(21)00152-5","article-title":"A comparison of sunitinib with cabozantinib, crizotinib, and savolitinib for treatment of advanced papillary renal cell carcinoma: A randomised, open-label, phase 2 trial","volume":"397","author":"Pal","year":"2021","journal-title":"Lancet"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1056\/NEJMoa2026982","article-title":"Nivolumab plus Cabozantinib versus Sunitinib for Advanced Renal-Cell Carcinoma","volume":"384","author":"Choueiri","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.1200\/JCO.21.01944","article-title":"Phase II Trial of Cabozantinib Plus Nivolumab in Patients With Non-Clear-Cell Renal Cell Carcinoma and Genomic Correlates","volume":"40","author":"Lee","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1016\/S1470-2045(15)00290-9","article-title":"Lenvatinib, everolimus, and the combination in patients with metastatic renal cell carcinoma: A randomised, phase 2, open-label, multicentre trial","volume":"16","author":"Motzer","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/S1470-2045(21)00241-2","article-title":"Lenvatinib plus pembrolizumab in patients with either treatment-naive or previously treated metastatic renal cell carcinoma (Study 111\/KEYNOTE-146): A phase 1b\/2 study","volume":"22","author":"Lee","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1056\/NEJMoa1303989","article-title":"Pazopanib versus sunitinib in metastatic renal-cell carcinoma","volume":"369","author":"Motzer","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1200\/JCO.2009.23.9764","article-title":"Pazopanib in locally advanced or metastatic renal cell carcinoma: Results of a randomized phase III trial","volume":"28","author":"Sternberg","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3312","DOI":"10.1200\/JCO.2008.19.5511","article-title":"Sorafenib for treatment of renal cell carcinoma: Final efficacy and safety results of the phase III treatment approaches in renal cancer global evaluation trial","volume":"27","author":"Escudier","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1056\/NEJMoa065044","article-title":"Sunitinib versus interferon alfa in metastatic renal-cell carcinoma","volume":"356","author":"Motzer","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/S1470-2045(19)30735-1","article-title":"Tivozanib versus sorafenib in patients with advanced renal cell carcinoma (TIVO-3): A phase 3, multicentre, randomised, controlled, open-label study","volume":"21","author":"Rini","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Arena, C., Troiano, G., De Lillo, A., Testa, N.F., and Lo Muzio, L. (2018). Stomatitis and VEGFR-Tyrosine Kinase Inhibitors (VR-TKIs): A Review of Current Literature in 4369 Patients. Biomed. Res. Int., 2018.","DOI":"10.1155\/2018\/5035217"},{"key":"ref_60","first-page":"73","article-title":"Recurrent aphthous stomatitis (RAS): Guideline for differential diagnosis and management","volume":"23","author":"Milia","year":"2022","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_61","first-page":"196","article-title":"Molecularly targeted drugs for the treatment of cancer: Oral complications and pathophysiology","volume":"16","author":"Dietrich","year":"2012","journal-title":"Hippokratia"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.ejcsup.2013.07.016","article-title":"Understanding and managing toxicities of vascular endothelial growth factor (VEGF) inhibitors","volume":"11","author":"Schmidinger","year":"2013","journal-title":"EJC Suppl."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/154405910508400105","article-title":"Zinc gluconate in the treatment of dysgeusia\u2014A randomized clinical trial","volume":"84","author":"Heckmann","year":"2005","journal-title":"J. Dent. Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/chemse\/bjaa038","article-title":"Identifying Treatments for Taste and Smell Disorders: Gaps and Opportunities","volume":"45","author":"Mainland","year":"2020","journal-title":"Chem. Senses"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Nolden, A.A., Hwang, L.D., Boltong, A., and Reed, D.R. (2019). Chemosensory Changes from Cancer Treatment and Their Effects on Patients\u2019 Food Behavior: A Scoping Review. Nutrients, 11.","DOI":"10.3390\/nu11102285"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Pellegrini, M., Merlo, F.D., Agnello, E., Monge, T., Devecchi, A., Casalone, V., Montemurro, F., Ghigo, E., Sapino, A., and Bo, S. (2023). Dysgeusia in Patients with Breast Cancer Treated with Chemotherapy\u2014A Narrative Review. Nutrients, 15.","DOI":"10.3390\/nu15010226"},{"key":"ref_67","first-page":"e27908","article-title":"Chemotherapy-Induced Dysgeusia and Its Perverse Consequences: A Case Report","volume":"14","author":"Pombo","year":"2022","journal-title":"Cureus"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ejca.2017.09.006","article-title":"Insight in taste alterations during treatment with protein kinase inhibitors","volume":"86","author":"Rovithi","year":"2017","journal-title":"Eur. J. Cancer"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Fu, Z.H., Zhao, C., Wang, Y., Zhang, L., and Wang, L. (2025). Pharmacovigilance imbalance analysis of VEGFR-TKI-related taste and smell disorders. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-87678-1"},{"key":"ref_70","first-page":"31","article-title":"The neuroprotective function of vascular endothelial growth factor (VEGF)","volume":"43","year":"2005","journal-title":"Folia Neuropathol."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Walsh, M., Fagan, N., and Davies, A. (2023). Xerostomia in patients with advanced cancer: A scoping review of clinical features and complications. BMC Palliat. Care, 22.","DOI":"10.1186\/s12904-023-01276-4"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ejpb.2019.06.016","article-title":"Saliva: An all-rounder of our body","volume":"142","author":"Roblegg","year":"2019","journal-title":"Eur. J. Pharm Biopharm."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/S0885-3924(01)00318-9","article-title":"Xerostomia in patients with advanced cancer","volume":"22","author":"Davies","year":"2001","journal-title":"J. Pain Symptom Manag."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1177\/1534735417728336","article-title":"Herbal Medicine for Xerostomia in Cancer Patients: A Systematic Review of Randomized Controlled Trials","volume":"17","author":"Park","year":"2018","journal-title":"Integr. Cancer Ther."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1093\/ijpp\/riac051","article-title":"A retrospective study of drugs associated with xerostomia from the Australian Database of Adverse Event Notifications","volume":"30","author":"Choo","year":"2022","journal-title":"Int. J. Pharm. Pract."},{"key":"ref_76","first-page":"26","article-title":"Oral adverse events associated with targeted cancer therapies","volume":"66","author":"Chmieliauskaite","year":"2018","journal-title":"Gen. Dent."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e38561","DOI":"10.1016\/j.heliyon.2024.e38561","article-title":"Disproportionality analysis of drug-induced dry mouth using data from the United States food and drug administration adverse event reporting system database","volume":"10","author":"Xu","year":"2024","journal-title":"Heliyon"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1834-7819.2005.tb00360.x","article-title":"The oral health assessment tool\u2014Validity and reliability","volume":"50","author":"Chalmers","year":"2005","journal-title":"Aust. Dent. J."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.biopha.2018.02.056","article-title":"Effects of sunitinib targeted chemotherapy on the osseointegration of titanium implants","volume":"100","author":"Marei","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"R247","DOI":"10.1530\/ERC-12-0400","article-title":"Effects of tyrosine kinase inhibition on bone metabolism: Untargeted consequences of targeted therapies","volume":"21","author":"Aleman","year":"2014","journal-title":"Endocr. Relat. Cancer"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1111\/odi.14065","article-title":"Effect of tyrosine kinase inhibitor sunitinib on tissue repair at tooth extraction sites","volume":"29","author":"Ratzkowski","year":"2023","journal-title":"Oral Dis."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Alam, M.K., Awawdeh, M., Khanagar, S.B., Aboelmaaty, W., Abutayyem, H., Alswairki, H.J., Alfawzan, A.A., and Hajeer, M.Y. (2023). A Systematic Review and Meta-Analysis of the Impact of Cancer and Its Treatment Protocol on the Success of Orthodontic Treatment. Cancers, 15.","DOI":"10.3390\/cancers15225387"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Bunta, O., Festila, D., Muresan, V., Colo\u0219i, T., Stan, O.P., Unguresan, M.L., and Baciut, M. (2023). Mathematical Modeling and Digital Simulation of Teeth Dynamics for the Approximation of Orthodontic Treatment Duration. Appl. Sci., 13.","DOI":"10.3390\/app13105932"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Ahdi, H.S., Wichelmann, T.A., Pandravada, S., and Ehrenpreis, E.D. (2023). Medication-induced osteonecrosis of the jaw: A review of cases from the Food and Drug Administration Adverse Event Reporting System (FAERS). BMC Pharmacol. Toxicol., 24.","DOI":"10.1186\/s40360-023-00657-y"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"151","DOI":"10.11005\/jbm.2015.22.4.151","article-title":"Medication Related Osteonecrosis of the Jaw: 2015 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons","volume":"22","author":"Kim","year":"2015","journal-title":"J. Bone Metab."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5125\/jkaoms.2019.45.1.3","article-title":"Osteonecrosis of the jaw in the era of targeted therapy and immunotherapy in oncology","volume":"45","author":"Zuccarello","year":"2019","journal-title":"J. Korean Assoc. Oral Maxillofac. Surg."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/jbmr.2405","article-title":"Diagnosis and management of osteonecrosis of the jaw: A systematic review and international consensus","volume":"30","author":"Khan","year":"2015","journal-title":"J. Bone Miner. Res."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Lon\u010dar Brzak, B., Horvat Aleksijevi\u0107, L., Vindi\u0161, E., Kordi\u0107, I., Grani\u0107, M., Vidovi\u0107 Juras, D., and Andabak Rogulj, A. (2023). Osteonecrosis of the Jaw. Dent. J., 11.","DOI":"10.3390\/dj11010023"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s10006-020-00913-z","article-title":"Osteonecrosis of the jaws associated with protein kinase inhibitors: A systematic review","volume":"25","author":"Mian","year":"2021","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Wang, S., Zhang, R., Wang, S., Guo, Q., Yin, D., Song, Y., She, X., Wang, X., and Duan, J. (2024). Osteonecrosis of the jaw in patients with clear cell renal cell carcinoma treated with targeted agents: A case series and large-scale pharmacovigilance analysis. Front. Pharmacol., 15.","DOI":"10.3389\/fphar.2024.1309148"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Konarski, W., Pobo\u017cy, T., Konarska, K., \u015aliwczy\u0144ski, A., Kotela, I., and Krakowiak, J. (2024). Exploring the Impact of Novel Anti-Cancer Therapies on Jaw Osteonecrosis and Other Bones: A Comprehensive Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13071889"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.clgc.2014.12.002","article-title":"Osteonecrosis of the Jaw in Patients With Metastatic Renal Cell Cancer Treated With Bisphosphonates and Targeted Agents: Results of an Italian Multicenter Study and Review of the Literature","volume":"13","author":"Fusco","year":"2015","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"E1424","DOI":"10.1503\/cmaj.202855","article-title":"Geographic tongue","volume":"193","author":"Prasanth","year":"2021","journal-title":"CMAJ"},{"key":"ref_94","first-page":"e2021043","article-title":"Bevacizumab-Induced Geographic Tongue","volume":"11","year":"2021","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1590\/abd1806-4841.20164288","article-title":"Geographic tongue and psoriasis: Clinical, histopathological, immunohistochemical and genetic correlation\u2014A literature review","volume":"91","author":"Picciani","year":"2016","journal-title":"An. Bras. Dermatol."},{"key":"ref_96","unstructured":"Shareef, S., and Ettefagh, L. (2023). Geographic Tongue, StatPearls Publishing."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Sarruf, M.B.J.M., Quinelato, V., Sarruf, G.J.M., Oliveira, H.E., Calasans-Maia, J.A., Quinelato, H., Aguiar, T., Casado, P.L., and Cavalcante, L.M.A. (2022). Stress as worsening of the signs and symptoms of the geographic tongue during the COVID-19 pandemic: A pilot study. BMC Oral Health, 22.","DOI":"10.1186\/s12903-022-02609-0"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1634\/theoncologist.2012-0320","article-title":"Geographic tongue induced by angiogenesis inhibitors","volume":"18","author":"Hubiche","year":"2013","journal-title":"Oncologist"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"bcr2015211318","DOI":"10.1136\/bcr-2015-211318","article-title":"Geographical tongue induced by axitinib","volume":"2015","author":"Sundar","year":"2015","journal-title":"BMJ Case Rep."},{"key":"ref_100","first-page":"1","article-title":"Geographic tongue (benign migratory glossitis) in a patient treated with Pazopanib for metastatic renal cell carcinoma","volume":"6","author":"Gilmore","year":"2016","journal-title":"Cancer Treat. Commun."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Adamo, D., and Spagnuolo, G. (2022). Burning Mouth Syndrome: An Overview and Future Perspectives. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20010682"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/jop.13064","article-title":"Is oral dysaesthesia a somatic symptom disorder?","volume":"49","author":"Kwong","year":"2020","journal-title":"J. Oral Pathol. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"295","DOI":"10.17219\/dmp\/120991","article-title":"Pharmacological and non-pharmacological management of burning mouth syndrome: A systematic review","volume":"57","author":"Reyad","year":"2020","journal-title":"Dent. Med. Probl."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1111\/odi.13868","article-title":"Worldwide prevalence estimates of burning mouth syndrome: A systematic review and meta-analysis","volume":"28","author":"Wu","year":"2022","journal-title":"Oral Dis."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4103\/0973-1075.173942","article-title":"Burning Mouth Syndrome","volume":"22","author":"Kamala","year":"2016","journal-title":"Indian J. Palliat. Care"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1177\/0022034518782462","article-title":"Recent advances in the etiology and treatment of burning mouth syndrome","volume":"97","author":"Ritchie","year":"2018","journal-title":"J. Dent. Res."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1177\/0333102416646769","article-title":"Role of psychological factors in burning mouth syndrome: A systematic review and meta-analysis","volume":"37","author":"Galli","year":"2017","journal-title":"Cephalalgia"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1634\/theoncologist.2010-0263","article-title":"Sunitinib in metastatic renal cell carcinoma: Recommendations for management of noncardiovascular toxicities","volume":"16","author":"Kollmannsberger","year":"2011","journal-title":"Oncologist"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1002\/JPER.17-0095","article-title":"Dental plaque-induced gingival conditions","volume":"89","author":"Murakami","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Veynachter, T., Orti, V., Moulis, E., Rousseau, H., Thilly, N., Anagnostou, F., Jeanne, S., and Bisson, C. (2020). Prevalence and Associated Factors of Self-Reported Gingival Bleeding: A Multicenter Study in France. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17228563"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/s41405-024-00291-8","article-title":"Drug-associated gingival disorders: A retrospective pharmacovigilance assessment using disproportionality analysis","volume":"11","author":"Sridharan","year":"2025","journal-title":"BDJ Open"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.tripleo.2011.08.024","article-title":"Gingival bleeding and jaw bone necrosis in patients with metastatic renal cell carcinoma receiving sunitinib: Report of 2 cases with clinical implications","volume":"113","author":"Migkou","year":"2012","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Papadopoulou, E., Vardas, E., Tziveleka, S., Georgaki, M., Kouri, M., Katoumas, K., Piperi, E., and Nikitakis, N.G. (2022). Oral Side Effects in Patients with Metastatic Renal Cell Carcinoma Receiving the Antiangiogenic Agent Pazopanib-Report of Three Cases. Dent. J., 10.","DOI":"10.3390\/dj10120232"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1038\/nrc2152","article-title":"Possible molecular mechanisms involved in the toxicity of angiogenesis inhibition","volume":"7","author":"Verheul","year":"2007","journal-title":"Nat. Rev. Cancer"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/j.eururo.2007.11.037","article-title":"Toxicities associated with the administration of sorafenib, sunitinib, and temsirolimus and their management in patients with metastatic renal cell carcinoma","volume":"53","author":"Bhojani","year":"2008","journal-title":"Eur. Urol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"734","DOI":"10.2165\/00003495-199447050-00003","article-title":"Treatment of oral Candida mucositis infections","volume":"47","author":"Garber","year":"1994","journal-title":"Drugs"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s40257-018-0384-3","article-title":"Toxic Side Effects of Targeted Therapies and Immunotherapies Affecting the Skin, Oral Mucosa, Hair, and Nails","volume":"19","author":"Lacouture","year":"2018","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1038\/s41415-024-7057-9","article-title":"Oral dysaesthesia: A special focus on aetiopathogenesis, clinical diagnostics and treatment modalities","volume":"236","author":"Farag","year":"2024","journal-title":"Br. Dent. J."},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Togni, L., Mascitti, M., Vignigni, A., Alia, S., Sartini, D., Barlattani, A., Emanuelli, M., and Santarelli, A. (2021). Treatment-Related Dysgeusia in Oral and Oropharyngeal Cancer: A Comprehensive Review. Nutrients, 13.","DOI":"10.3390\/nu13103325"},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Ito, K., Izumi, N., Funayama, S., Nohno, K., Katsura, K., Kaneko, N., and Inoue, M. (2023). Characteristics of medication-induced xerostomia and effect of treatment. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0280224"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.oooo.2018.09.008","article-title":"Medication-related osteonecrosis of the jaw: Definition and best practice for prevention, diagnosis, and treatment","volume":"127","author":"Mendes","year":"2019","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_122","first-page":"2662","article-title":"Treatment of medication-related osteonecrosis of the jaw (MRONJ). A systematic review","volume":"25","author":"Goker","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1177\/03331024211036152","article-title":"A systematic review of treatment for patients with burning mouth syndrome","volume":"42","author":"Tan","year":"2022","journal-title":"Cephalalgia"},{"key":"ref_124","first-page":"369","article-title":"Common Oral Lesions","volume":"105","author":"Randall","year":"2022","journal-title":"Am. Fam. Physician"}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/10\/439\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:48:54Z","timestamp":1760035734000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/10\/439"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":124,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["dj13100439"],"URL":"https:\/\/doi.org\/10.3390\/dj13100439","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]}}}