A growth factor that protects the mouth lining during intensive cancer treatment
Palifermin
A growth factor given to reduce severe mouth ulcers (oral mucositis) caused by intensive cancer treatment before a stem-cell transplant.
What is Palifermin?
Palifermin is a specialist supportive-care medicine used to reduce severe mouth ulcers, known as oral mucositis, in people having very intensive chemotherapy or radiotherapy before a stem-cell (bone-marrow) transplant. It works like a natural growth factor, encouraging the cells lining the mouth and gut to grow and repair so the lining is better protected. It is given into a vein around the treatment, not to cure cancer itself. Common effects include skin sensations such as tingling or redness, a thicker or coated feeling in the mouth, and changes in taste. It is used only as part of specialist transplant care.
Education and reference only. This is a plain-language guide to Palifermin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Palifermin is a supportive-care medicine used in cancer treatment, not a cancer treatment in itself. It is a man-made version of a natural growth factor that helps the cells lining the mouth and gut to grow and heal. It is used in people receiving very intensive chemotherapy or radiotherapy before a stem-cell transplant, where the treatment commonly causes painful, severe mouth ulcers called oral mucositis that can make eating, drinking and swallowing very difficult. By protecting and helping repair the mouth lining, palifermin reduces how severe and long-lasting these ulcers are. It is given as an injection into a vein, on specific days around the intensive treatment, under the care of a specialist transplant team.
How it works
The lining of the mouth and gut is made of fast-growing cells that are easily damaged by the very high doses of chemotherapy and radiotherapy used before a stem-cell transplant, which is what causes severe mouth ulcers. Palifermin acts like a natural growth factor for these lining cells, encouraging them to grow, thicken and repair. Given for a few days before the intensive treatment and again afterwards, it helps the mouth lining withstand the damage better, so the ulcers tend to be less severe, less painful and shorter-lasting. It does not treat the cancer; its whole purpose is to protect the lining and make the transplant process more bearable.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist medicine used in the UK to reduce severe mouth ulcers in people having intensive chemotherapy or radiotherapy before a stem-cell transplant.
Practical use
How to take Palifermin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given as an injection into a vein by your transplant team, on the specific days set out in your treatment plan.
- It is given for a few days before the intensive chemotherapy or radiotherapy and again afterwards, following a careful schedule.
- It is not given too close to the chemotherapy doses, as the timing affects how well it works, so the team spaces it correctly.
- Tell your team about skin sensations, mouth changes or taste changes, which are common and usually settle.
- Remember it is there to protect your mouth and gut lining, not to treat the cancer, which other treatments do.
Weighing it up
Advantages & disadvantages of Palifermin
Advantages
- Reduces how severe and long-lasting mouth ulcers (oral mucositis) are during intensive cancer treatment.
- Helps people keep eating, drinking and swallowing more comfortably through a stem-cell transplant.
- A targeted supportive treatment that helps the mouth and gut lining repair itself.
Disadvantages
- Commonly causes skin sensations such as tingling or redness, mouth changes and altered taste.
- Must be given on a precise schedule and kept apart in time from the chemotherapy itself.
- It is supportive care only and does not treat the cancer.
Practical use
Good to know
The most important thing to understand is that palifermin is a supportive medicine: it protects the mouth and gut lining during intensive cancer treatment rather than treating the cancer itself. It is given on a careful schedule, with doses before and after the intensive chemotherapy or radiotherapy, and the timing matters, so it must not be given too close to the chemotherapy itself. Common, generally mild effects include skin sensations such as tingling, redness or a rash, a thickened or coated feeling and discolouration in the mouth, and changes in taste, all of which usually settle. Because it encourages lining cells to grow, the team gives it as part of a planned transplant protocol and watches how the mouth responds. It is used only within specialist transplant care, where the benefits of fewer severe ulcers are weighed for each person.
Who should not take it / use with caution
- People who have had a serious allergic reaction to palifermin should not be given it.
- It is used with care, and under specialist judgement, in pregnancy, where the team weighs the benefits and risks.
- It is given only as part of specialist transplant care, under close supervision.
Monitoring
- Watching how severe the mouth ulcers are and how well the mouth lining is protected.
- Checking for skin, mouth and taste effects and managing any that arise.
- Reviewing it as part of the overall transplant treatment plan.
Side effects
- Skin sensations such as tingling, redness, itching or a rash, which usually settle.
- A thickened, coated feeling or discolouration in the mouth, and changes in taste.
- Swelling, joint aches or a raised temperature in some people.
- Rarely, more troublesome reactions, which the transplant team watches for and manages.
Key interactions
- It must be kept apart in time from the chemotherapy itself, as giving it too close together can reduce its benefit.
- There are few other well-established routine medicine interactions, but the team plans it around the whole treatment schedule.
- Always make sure the team has a full list of your other medicines.
Available as: A powder made up into a solution for injection into a vein.
Answers
Palifermin: frequently asked questions
What is palifermin used for?
It is used as supportive care to reduce severe mouth ulcers (oral mucositis) in people having intensive chemotherapy or radiotherapy before a stem-cell transplant.
Does palifermin treat cancer?
No. It is a supportive medicine that protects and helps repair the mouth and gut lining; other treatments are used to treat the cancer itself.
Why is the timing so important?
It must be kept apart in time from the chemotherapy, with doses before and after, because giving it too close to the chemotherapy can reduce how well it works.
Why has my mouth changed or food tastes different?
A thicker or coated feeling in the mouth and changes in taste are common effects of palifermin and usually settle after treatment.
Why do I have tingling or redness on my skin?
Skin sensations such as tingling, redness or a rash are common, generally mild effects of palifermin; tell your team, but they usually settle on their own.
Authoritative sources
- BNF
- NICE CKS
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