Patients’ Satisfaction with Breakthrough Cancer Pain Therapy: A Secondary Analysis of IOPS-MS Study

Mazzotta, Marco; Filetti, Marco; Piras, Marta M.; Mercadante, Sebastiano; Marchetti, Paolo; Giusti, Raffaele

doi:10.2147/cmar.s353036

Cited by 6 publications

(4 citation statements)

References 30 publications

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“…This requires patients to wake up in the middle of the night to take an opioid dose. 77 Dose titration can be done a few days after each dose increase or reduction. Because of the wide variation in individual opioid dose response, the increase or decrease in opioid daily dose is calculated as a percentage of the total daily dose (usually approximately 25%-50%).…”

Section: Clinical Questionmentioning

confidence: 99%

Use of Opioids for Adults With Pain From Cancer or Cancer Treatment: ASCO Guideline

Paice

Bohlke

Barton

et al. 2023

JCO

Self Cite

100

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PURPOSE To provide guidance on the use of opioids to manage pain from cancer or cancer treatment in adults. METHODS A systematic review of the literature identified systematic reviews and randomized controlled trials of the efficacy and safety of opioid analgesics in people with cancer, approaches to opioid initiation and titration, and the prevention and management of opioid adverse events. PubMed and the Cochrane Library were searched from January 1, 2010, to February 17, 2022. American Society of Clinical Oncology convened an Expert Panel to review the evidence and formulate recommendations. RESULTS The evidence base consisted of 31 systematic reviews and 16 randomized controlled trials. Opioids have primarily been evaluated in patients with moderate-to-severe cancer pain, and they effectively reduce pain in this population, with well-characterized adverse effects. Evidence was limited for several of the questions of interest, and the Expert Panel relied on consensus for these recommendations or noted that no recommendation could be made at this time. RECOMMENDATIONS Opioids should be offered to patients with moderate-to-severe pain related to cancer or active cancer treatment unless contraindicated. Opioids should be initiated PRN (as needed) at the lowest possible dose to achieve acceptable analgesia and patient goals, with early assessment and frequent titration. For patients with a substance use disorder, clinicians should collaborate with a palliative care, pain, and/or substance use disorder specialist to determine the optimal approach to pain management. Opioid adverse effects should be monitored, and strategies are provided for prevention and management. Additional information is available at www.asco.org/supportive-care-guidelines .

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Section: Clinical Questionmentioning

confidence: 99%

Use of Opioids for Adults With Pain From Cancer or Cancer Treatment: ASCO Guideline

Paice

Bohlke

Barton

et al. 2023

JCO

Self Cite

100

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“…134 Correct management of BTcP allows for significant improvement in the QoL of these patients. [135][136][137] TIRF is the treatment of choice for BTcP due to its pharmacological properties, including rapid onset, increased potency and short half-life. 4,26,138 Conversely, oral immediate-release opioids can be used to treat slow-onset or predictable BTcP.…”

Section: Commentmentioning

confidence: 99%

“… 134 Correct management of BTcP allows for significant improvement in the QoL of these patients. 135 – 137 …”

Section: Case Reportsmentioning

confidence: 99%

Multidisciplinary approach, continuous care and opioid management in cancer pain: case series and review of the literature

Porzio¹,

Capela²,

Giusti³

et al. 2023

DIC

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Underlying cancer pain has heterogenous aetiologies and mechanisms. It requires detailed and comprehensive pain assessment, combined with personalized treatment. A multidisciplinary team is essential to providing the best management of cancer pain at every disease stage, improving the quality of life and outcomes in patients with cancer. This narrative literature review emphasizes the value of providing all patients with multidisciplinary pain management in their preferred care setting. Real-life experiences are also reported to witness the efforts of physicians to properly manage cancer pain.

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“…The alpha-emitter, radium-233 (Ra-233) was the first targeted alpha therapy approved by the United States (US) Food and Drug Administration (FDA) [ 50 , 62 ] and the European Medicines Agency (EMA) [ 84 ]. Importantly, Ra-233 has a significant survival benefit, both in overall survival (OS) and in the time to the first symptomatic SRE [ 84 , 95 ].…”

Section: Radiotherapy and Bone-targeting Agents For Relief Of Metasta...mentioning

confidence: 99%

Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials

2022

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Purpose Metastatic spread of prostate cancer to the skeleton may result in debilitating bone pain. In this review, we address mechanisms underpinning the pathobiology of metastatic prostate cancer induced bone pain (PCIBP) that include sensitization and sprouting of primary afferent sensory nerve fibres in bone. We also review current treatments and pain responses evoked by various treatment modalities in clinical trials in this patient population. Methods We reviewed the literature using PubMed to identify research on the pathobiology of PCIBP. Additionally, we reviewed clinical trials of various treatment modalities in patients with PCIBP with pain response outcomes published in the past 7 years. Results Recent clinical trials show that radionuclides, given either alone or in combination with chemotherapy, evoked favourable pain responses in many patients and a single fraction of local external beam radiation therapy was as effective as multiple fractions. However, treatment with chemotherapy, small molecule inhibitors and/or immunotherapy agents, produced variable pain responses but pain response was the primary endpoint in only one of these trials. Additionally, there were no published trials of potentially novel analgesic agents in patients with PCIBP. Conclusion There is a knowledge gap for clinical trials of chemotherapy, small molecule inhibitors and/or immunotherapy in patients with PCIBP where pain response is the primary endpoint. Also, there are no novel analgesic agents on the horizon for the relief of PCIBP and this is an area of large unmet medical need that warrants concerted research attention.

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Patients’ Satisfaction with Breakthrough Cancer Pain Therapy: A Secondary Analysis of IOPS-MS Study

Cited by 6 publications

References 30 publications

Use of Opioids for Adults With Pain From Cancer or Cancer Treatment: ASCO Guideline

Use of Opioids for Adults With Pain From Cancer or Cancer Treatment: ASCO Guideline

Multidisciplinary approach, continuous care and opioid management in cancer pain: case series and review of the literature

Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials

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