1444P Intravenous (IV) patient-controlled analgesia (PCA) vs oral opioid to maintain analgesia for severe cancer pain after successful hydromorphone (HM) titration: A multi-center, phase II randomized trial (HMORCT09-2)

Abstract

value for recommending transfusion was 6.0 g/dL, whereas only 41.4% PCs responded that they would recommend transfusion therapy even if the Hb value was <6.0 g/dL. As Hb value <6.0 g/dL was not provided as an option in the responses, the cutoff considered by PCs could not be determined. For symptomatic inpatient cases, more than 70% of HOs and PCs considered Hb cutoffs of 8.0 and 7.0 g/dL, respectively. Most HOs (76.1%) and PCs (71.1%) agreed to reduce the frequency of transfusion therapy (p¼0.119), and PCs more likely agreed to discontinue transfusion therapy than HOs (19.7% vs. 9.3%, p<0.001). More HOs, than PCs, agreed to continue transfusion therapy until patients and/or families required it (52.4% vs. 17.8%, p<0.001). More HOs, than PCs, considered patients with performance status 4 as being eligible for transfusion (39.5% vs. 18.6%, p<0.001).Conclusions: There are differences in the opinions of HOs and PCs regarding the indication for undergoing transfusion therapy for patients with end-stage hematological malignancies. In the future, it is expected that the referral rate of palliative care for patients with end-stage hematological malignancies will increase through mutual understanding and consensus on transfusion therapy.

Intravenous Patient-Controlled Analgesia Versus Oral Opioid to Maintain Analgesia for Severe Cancer Pain: A Randomized Phase II Trial

“…A large, multicenter phase III trial is ongoing to address this issue. 36 Second, the portable pump may not be feasible for all patients with persistent cancer pain needing a long-term intervention, although it is appropriate for short-term use. We believe that even more convenient formulations, such as intranasal drug delivery with rapid onset and appropriate half-life opioids, can be developed when the safety and efficacy of bolus-only PRN is established.…”

“…The small sample also limits a comparison of opioid-naïve versus opioid-tolerant patients; however, this will be resolved in a future phase III study with a larger sample size. 36…”