Multinational ADOPT Study Seeks Further Improvement in Management of Oral Mucositis

June 30, 2016 - 11 minutes read

Achieving optimal management of oral mucositis will improve the wellbeing of patients undergoing cancer treatment

 Singapore, 27 June 2016 – A new study titled ADOPT (Awareness Drives Oral Mucositis PercepTive) has highlighted an opportunity to improve the wellbeing of patients undergoing cancer treatment through stronger proactive management of oral mucositis (OM).

OM is a common side effect of cancer treatment that results in inflammation and/or ulcerative sores in the lining of the mouth or throat. Mundipharma Pte. Ltd., a leading pharmaceutical company in cancer supportive care, sponsored the ADOPT Study that was carried out in two phases between April to September 2015 in Hong Kong, Malaysia, Singapore, Taiwan, South Korea, Philippines and Saudi Arabia. The study involved 175 cancer patients diagnosed with OM and 105 oncologists managing the condition.

The study revealed that 70% of oncologists and 80% patients rank OM as one of the top three most important side effects to treat. However, while the presence and potential of OM is acknowledged and treated by oncologists, more could potentially be done to proactively prescribe treatment prior to the onset of OM symptoms.

The study showed that while up to 85% of oncologists place a greater emphasis on relieving and delaying OM symptoms to complete cancer treatment, less than half (46%) of the oncologists initiated prophylactics for OM at the beginning of cancer therapies, with only 16% of patients acknowledging that medications were given to them before the onset of OM symptoms.

According to the study, oncologists recognize that OM can have an impact on cancer treatment outcomes due to adjustment of treatment regimen or the disruption of chemotherapy or radiotherapy if the OM becomes severe. For patients with moderate-to-severe OM, 70% of physicians will delay patient’s chemotherapy/radiotherapy, and over 50% will re-adjust cancer drug dosages.

“Even though the negative implications of oral mucositis on cancer therapy as well as quality of life are well known, the ADOPT study has demonstrated that the proactive management of oral mucositis can be improved,” said Dr Jeeve Kanagalingam, Head and Neck Cancer Surgeon, Investigator of ADOPT study. “Enhanced proactive management may improve cancer treatment outcomes, reduce the disease and financial burden and improve patients’ quality of life.”

Dr Kanagalingam added: “Currently, there is limited well-established evidence on agents that may reduce the incidence and severity of oral mucositis. Guidelines have suggested improving oral health could be critical to reduce disease severity. Some studies have suggested that povidone iodine mouthwashes, also commonly known as BETADINE®, due to its antiseptic, anti-inflammatory and haemostatic properties, may play a suitable role OM management.”

Raman Singh, President, Mundipharma Asia Pacific, Latin America, Middle East and Africa, stated, “These results from the survey demonstrate an opportunity to improve outcomes for patients undergoing therapy through better OM prevention and management measures.”

“Significant strides have been made in the cancer care arena and making informed decisions as to the suitability of a product for the management of OM is an important, albeit complex, task. We are confident that the BETADINE® Gargle and Mouthwash can be an effective and economical supportive treatment option for OM,” he said.

Understanding, preventing and managing OM

OM is a common complication that occurs in patients receiving chemotherapy or radiotherapy involving the oral cavity. It is inflammation and/or ulcerative sores in the lining of the mouth or throat.1,2 OM is more likely to be caused by some types of cancer and their treatments,3,4 for example, OM occurs in virtually all patients with head and neck cancer receiving radiotherapy3 and in up to 68% of patients receiving chemotherapy.4 When OM manifests, it can be challenging and costly to manage.5

As OM can cause pain, it creates an adverse impact on patients’ quality of life and wellbeing.2,6 Pain from OM may compromise food or nutritional intake and cause weight loss, which becomes more significant as the symptoms worsen.6,7

Although there is no modality that can entirely prevent OM, prophylactic measures to reduce the occurrence and severity of OM are often more affordable and readily available compared with OM treatments. Good oral care remains the cornerstone for reducing the chances of developing OM.2, 8, 9 If and when OM develops, regular brushing and flossing, as well as rinsing with antiseptic mouth rinses can prevent infections and keep the mouth moisturized.2 Using a PVP-I mouthwash can also help to reduce the severity of symptoms and reduce the duration of OM,18,12 probably through controlling inflammation and removing free radicals,13,15 both of which are important components in the development of OM.16

BETADINE® Gargle and Mouthwash leads to faster recovery

BETADINE® Gargle and Mouthwash is an oral germicide that contains the active compound PVP-I.17 Studies have shown that, compared with salt solution, BETADINE® Gargle and Mouthwash reduces the severity of OM symptoms, enabling a faster recovery for cancer patients.21 It also demonstrates less severe and delays the onset of OM symptoms compared with other commercially available mouthwashes.12, 18, 21, 22

Additionally, OM can be complicated by bacterial, viral and fungal infections.19 The use of BETADINE® Gargle and Mouthwash as part of an oral hygiene protocol can help to reduce opportunistic infection.20 Even with prolonged use (8–10 weeks), BETADINE® Gargle and Mouthwash does not irritate or damage the oral mucosa,21 allowing for an effective and cost-effective early intervention and treatment option for OM.

 Approved indications differ country to country. Please refer to your local Mundipharma representative office for the locally approved prescribing information for more details on the product and indications. Mundipharma Pte Ltd provides this information for Asia, Middle East and Latin America.

 About Mundipharma

Mundipharma’s independent associated companies are privately owned entities covering the world’s pharmaceutical markets. Mundipharma is a prime example of a company that consistently delivers high quality products while standing by the values that represent the company. Our mission is to alleviate the suffering of patients with cancer and non-cancer pain and to substantially improve their quality of life. Mundipharma is dedicated to bringing to patients with severe and debilitating diseases the benefit of novel treatment options in fields such as pain, oncology, ophthalmology, respiratory disease, rheumatoid arthritis and antiseptics. In efforts to combat infectious diseases around the world, Mundipharma has and continues to donate BETADINE® products.

For more information please visit:


The BETADINE® (Povidone-Iodine) range of products is trusted by hospitals around the world for over 60 years to prevent and treat infections. It is a trusted brand among consumers at home to treat small wounds and grazes, sore throats, feminine infections. This stops minor problems from escalating into big issues. In-vitro studies show that Povidone-iodine, the key active ingredient of BETADINE® kills a broad range of germs that cause infections. BETADINE® has main categories of products in Wound Care, Throat / Oral Care and Feminine Care.

®: BETADINE is a Registered Trademark


  1. Lalla RV, et al. Cancer 2014;120:1453–1461.
  2. The Oral Cancer Foundation. Mucositis. Available at: Accessed March 2016.
  3. Al-Ansari S, et al. Curr Oral Heal Reports 2:202–211.
  4. Nishimura N, et al. Support Care Cancer 2012;20:2053-2059.
  5. Nooka AK, et al. Biol Blood Marrow Transplant 2014;20:852–857.
  6. Elting LS, et al. Cancer 2003;98:1531–1539.
  7. Miyano K, et al. Curr Pharm Des 2016 Feb 19 [Epub ahead of print].
  8. Cancer Care Ontario Working Group. Cancer Care Ontario’s Symptom Management Guide-to-Practice: Oral Care. July 2012.
  9. National Institutes for Health National Cancer Institute. Oral complications of chemotherapy and head/neck radiation–for health professionals (PDQ®). 2016. Available at: Accessed June 2016.
  10. Napenas JJ, et al. Gen Dent 2007;55:335–344.
  11. Peterson DE, et al. Ann Oncol 2011;22(Suppl 6):vi78–vi84.
  12. Adamietz IA, et al. Support Care Cancer 1998;6:373–377.
  13. König B, et al. Dermatology 1997;195(Suppl 2):42–48.
  14. Beukelman CJ, et al. Burns 2008;34:845–855.
  15. Eming SA, et al. J Invest Dermatol 2006;126:2731–2733.
  16. Biswal BM. Malays J Med Sci. 2008 Jul;15(3):4–13.
  17. BETAISODONA® Mouthwash/Gargle Summary of Product Characteristics. Mundipharma Pte Ltd 2014.
  18. Madan PDK, et al. J Cancer Res Ther. 2008 Jan-Mar;4(1):3–8.
  19. Lalla RV, et al. Dent Clin North Am 2008;52:61–viii.
  20. Yoneda S, et al. Jpn J Infect Dis 2007;60:23–28.
  21. Rahn R, et al. Dermatology. 1997;195 Suppl 2:57-61.
  22. Prejzner W, et al. Acta Haematologica Polonica. 2004;35(4);559-566.