TROP2 antibody−drug conjugates (ADCs), such as sacituzumab govitecan, sacituzumab tirumotecan, and datopotamab deruxtecan, have transformed cancer treatment but are frequently associated with oral mucositis (OM), a debilitating adverse event affecting 10% to 72.7% of patients, depending on the ADC type. OM significantly impacts patients’ nutritional intake, quality of life, and treatment adherence, emphasizing the need for evidence-based nursing interventions. This article reports results from a study of a multidisciplinary nursing pathway focused on patient education, risk-stratified prevention, and dental integration to mitigate OM severity and improve clinical outcomes.
The intervention design of this study was structured into 3 core components aimed at mitigating the severity of OM in patients receiving TROP2 ADC therapy. First, patient education was prioritized through structured workshops and visual aids, which provided guidance on best practices for oral hygiene, including the daily use of soft-bristle toothbrushes, alcohol-free mouthwash, and dietary modifications such as avoiding spicy or hot foods. To ensure early identification of OM symptoms, patients were provided with Common Terminology Criteria for Adverse Events–based symptom diaries to document signs and facilitate timely reporting. Second, a risk-stratified early-prevention strategy was implemented to target high-risk patients, who were identified based on factors such as prior radiotherapy or diabetes. These patients received Kangfuxin liquid, a traditional Chinese medicine derived from American cockroach extract, as well as mucosal protectants to enhance barrier function and reduce the risk of OM development. Third, dental integration played a critical role in the intervention. All patients underwent mandatory pretreatment dental assessments by dental specialists to address oral health issues such as caries, periodontitis, and ill-fitting dentures that could exacerbate OM. Weekly dental evaluations during ADC therapy ensured tailored interventions and minimized mechanical trauma.
Between October 2024 and April 2025, 40 patients receiving TROP2 ADC therapy (28 treated with sacituzumab tirumotecan and 12 with sacituzumab govitecan) were enrolled. All patients participated in the patient education program and early-prevention strategies, and 80% (32/40) underwent systematic dental integration to identify and resolve oral comorbidities. The incidence of severe OM (grade ≥3) was significantly reduced, and no patients required treatment discontinuation due to OM.
This study demonstrates that patient education, risk-stratified prevention, and dental integration are critical in managing OM associated with TROP2 ADC therapy. The implementation of a standardized, multidisciplinary nursing pathway successfully reduced the severity and incidence of OM, ensuring better patient outcomes and uninterrupted cancer treatment. These findings highlight the importance of integrating evidence-based nursing interventions into routine oncology practice.
Source: Song C, Wu X. Optimizing nursing care for TROP2 ADC-related oral mucositis: emphasizing patient education, early prevention, and dental integration. Presented at: ESMO Congress 2025. October 20, 2025; Berlin, Germany. Abstract CN94.