Patients with gastrointestinal stromal tumors (GISTs) who undergo treatment with tyrosine kinase inhibitors (TKIs) often experience medication-induced changes in their mouthfeel and senses of taste and smell, according to a study published in Supportive Care in Cancer.

Results showed that 38%, 23%, and 55% of patients with GIST on TKIs experienced taste, smell, and mouthfeel disturbances, respectively. Investigators reported that salty and sweet tastes were predominantly altered.

Of the 23% of patients with smell alterations, 27% experienced a diminished sense of smell, 20% experienced new unpleasant smells, and 60% experienced changes in familiar scents. Of the 55% of patients with mouthfeel disturbances, 45% experienced dry mouth, 22% experienced different tactile sensations in the mouth, 0.06% reported alterations in food temperature perception, and 0.03% reported a preference for other textures.

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Changes in taste impacted daily life and quality of life (QoL) (80% and 60%) more than changes in smell (47% and 31%) or mouthfeel (47% and 30%). Changes in taste only occurred in 22% of all patients, whereas 20% reported combined taste and smell disturbances, according to the patient questionnaires.

“Taste, smell, and mouthfeel disturbances lead to a lower QoL and could decrease nutritional intake, [so] healthcare professionals should be aware of [these side effects and discuss them] with the patient before starting with a TKI,” the authors said.

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They also recommended that patients with altered taste, smell, or mouthfeel “can be referred to a dietician for support and [advice] on the adjustments of their diet” as well as referral to a dental surgeon for “oral hygiene education and oral care to improve comfort.”

Researchers obtained data from 65 patients with GIST between July 2019 and January 2020. The investigators documented that 79%, 12%, and 9% of these patients currently used imatinib (the first-line TKI), sunitinib (the second-line TKI), and regorafenib (the third-line TKI), respectively. Most of the patients used TKIs for longer than 12 months, with a median treatment duration of 30 months.

The first section of the questionnaire assessed alterations in taste, smell, and mouthfeel and how these changes impacted daily life and QoL on a 4-point Likert scale. The second section assessed taste change severity, the type of tastes (sweet, sour, salty, or bitter) affected, the specific degree of change for each taste type, and coping mechanisms. The third section assessed smell change severity, specific odors, coping mechanisms, and methods of avoidance.

Limitations included the small sample sizes of patients taking sunitinib and regorafenib compared with imatinib, the subjective nature of patient reporting, and potential underreporting of taste and smell disturbances due to lead-time bias.  


Van Elst JM, IJzerman NS, Mathijssen RHJ, Steeghs N, Reyners AKL, de Haan JJ. Taste, smell and mouthfeel disturbances in patients with gastrointestinal stromal tumors treated with tyrosine-kinase inhibitors. Support Care Cancer. Published online November 2, 2021. doi:10.1007/s00520-021-06658-z