Article
Medicine, General & Internal
Sebastiano Mercadante, Augusto Caraceni, Arturo Cuomo, Massimo Mammucari, Paolo Marchetti, Rocco Domenico Mediati, Silvia Natoli, Giuseppe Tonini
Summary: After one-month follow-up, cancer patients experienced a lower number of breakthrough pain episodes and peak intensity, potentially due to optimization of background analgesia. The principal characteristics of breakthrough pain did not change significantly, highlighting the importance of careful and continuous assessment for patients to alleviate the burden induced by breakthrough pain episodes.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Oncology
Sebastiano Mercadante, Marco Maltoni, Domenico Russo, Claudio Adile, Patrizia Ferrera, Romina Rossi, Marta Rosati, Alessandra Casuccio
Summary: In patients receiving low doses of opioids, the prevalence of breakthrough cancer pain (BTcP) was high, with many patients experiencing dissatisfaction with BTcP medications, especially oral morphine. Optimizing background analgesia may help limit the number of BTcP episodes.
Article
Oncology
Marco Mazzotta, Marco Filetti, Marta Piras, Sebastiano Mercadante, Paolo Marchetti, Raffaele Giusti
Summary: This study aims to identify factors that can predict patients' satisfaction with pain relief for breakthrough cancer pain (BTcP). The results showed that younger age, non metastatic cancer stage, high Karnofsky performance status, absence of anticancer treatment, and high BTcP interference in activities of daily living were positively correlated with dissatisfaction.
CANCER MANAGEMENT AND RESEARCH
(2022)
Review
Health Care Sciences & Services
Marco Cascella, Federica Monaco, Davide Nocerino, Elisabetta Chine, Roberta Carpenedo, Paola Picerno, Laura Migliaccio, Angela Armignacco, Giulia Franceschini, Sergio Coluccia, Piergiacomo Di Gennaro, Maura C. Tracey, Cira A. Forte, Mariangela Tafuri, Anna Crispo, Francesco Cutugno, Alessandro Vittori, Silvia Natoli, Arturo Cuomo
Summary: The study conducted a bibliometric network analysis on the use of ROOs for BTcP treatment, revealing trends in published articles, distribution in journals, and main research topics. Most articles focused on the efficacy of ROOs, while abuse and misuse issues were not sufficiently addressed. Additionally, the semantic network analysis showed connections between breakthrough cancer pain, opioids, and cancers.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2022)
Article
Pharmacology & Pharmacy
Sebastiano Mercadante, Russell K. Portenoy
Summary: Breakthrough cancer pain (BTcP) is a complex phenomenon that varies between individuals and may change over time. Personalized management requires appropriate assessment of BTcP patterns. The use of opioids, specifically fentanyl products with rapid onset and offset, is recommended. The optimal opioid dose remains a controversial topic, with conflicting recommendations regarding dosing strategies.
Editorial Material
Oncology
D. Max Smith, William D. Figg
Summary: This commentary reviews a recent trial on the relationship between COMT genotype and opioid dose requirements, and discusses the potential role of COMT and other genes (such as CYP2D6) in opioid therapy. It also provides an overview of the current evidence for germline pharmacogenetics and available resources for opioid pharmacogenetics.
Article
Pharmacology & Pharmacy
S. Mercadante, A. Caraceni, A. Cuomo, M. Mammucari, P. Marchetti, R. D. Mediati, S. Natoli, G. Tonini
Summary: The aim of this study was to characterize breakthrough pain (BTcP) in patients with multiple myeloma (MM). The results showed that BTcP in patients with MM was more predictable compared to other tumors, with the main trigger being physical activity. There were no differences in other BTcP characteristics, pattern of opioids used for background pain, and patient satisfaction and adverse effects.
EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
(2023)
Article
Pharmacology & Pharmacy
S. Mercadante, A. Caraceni, A. Cuomo, M. Mammucari, P. Marchetti, R. D. Mediati, S. Natoli, G. Tonini
Summary: This study aimed to characterize breakthrough pain (BTcP) in patients with multiple myeloma (MM). The study analyzed data from a large multicenter study of patients with BTcP, recording background pain intensity and opioid doses. The characteristics of BTcP, including the number of episodes, intensity, onset, duration, predictability, and interference with daily activities, were recorded. Opioids prescribed for BTcP, time to achieve pain relief, adverse effects, and patient satisfaction were assessed. Results showed that BTcP in MM patients was more predictable, with physical activity as the predominant trigger.
EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
(2023)
Article
Oncology
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Maria Caterina Pallotti, Marianna Ricci, Giuseppe Bonanno, Alessandra Casuccio
Summary: This study aimed to evaluate the efficacy and adverse effects of methadone as a first-line therapy in patients receiving low doses of opioids or none. Results showed that methadone provided good analgesia with limited adverse effects and minimal opioid-induced tolerance.
Article
Oncology
Paula Gonzalez Villarroel, Josep Guma Padro, Gloria Marquina, Noelia Martinez Janez, Emilio Esteban Gonzalez, Antonio Anton, Miguel Berzosa Sanchez, Alberto Rodrigo Caceres, Rafael Lopez-Lopez, Roberto Escala Cornejo, Pablo Borrega Garcia, Raquel Marse Fabregat, Beatriz Castelo Fernandez, Cristina Lopez Bermudo, Carlos Camps
Summary: This study evaluated the quality of life in patients with BTcP in Spanish medical oncology departments. The results showed that individualized BTcP therapy could improve patients' QoL.
Article
Oncology
M. Fallon, K. Dierberger, M. Leng, P. S. Hall, S. Allende, R. Sabar, E. Verastegui, D. Gordon, L. Grant, R. Lee, K. McWillams, G. D. Murray, L. Norris, C. Reid, T. A. Sande, A. Caraceni, S. Kaasa, B. J. A. Laird
Summary: This study suggests that omitting step 2 of the WHO ladder in cancer pain management and using low-dose strong opioids as an alternative can be more efficient and cost-effective, with fewer side effects.
ANNALS OF ONCOLOGY
(2022)
Article
Oncology
Antoine Lemaire, Yoann Pointreau, Berengere Narciso, Francois-Xavier Piloquet, Viorica Braniste, Jean-Marc Sabate
Summary: This study demonstrates that naloxegol is effective and well-tolerated in cancer pain patients with OIC, leading to an improvement in their quality of life.
SUPPORTIVE CARE IN CANCER
(2021)
Article
Oncology
Desiree R. Azizoddin, Robert Knoerl, Rosalind Adam, Daniela Kessler, James A. Tulsky, Robert R. Edwards, Andrea C. Enzinger
Summary: The US opioid epidemic has stigmatized opioid use in patients with advanced cancer, leading to negative impacts on pain management and communication with healthcare providers. Patients experienced stigma, fear, and guilt surrounding opioid use, as well as structural barriers to obtaining opioids, which exacerbated the challenges of self-managing chronic pain.
Review
Medicine, Research & Experimental
Celina G. Virgen, Neil Kelkar, Aaron Tran, Christina M. Rosa, Diana Cruz-Topete, Shripa Amatya, Elyse M. Cornett, Ivan Urits, Omar Viswanath, Alan David Kaye
Summary: Patients diagnosed with cancer often experience pain during treatment, and concerns about adverse effects and addiction may result in under-dosing of opioids. Therefore, there is a need for novel non-opioid pain treatments for cancer patients.
BIOMEDICINE & PHARMACOTHERAPY
(2022)
Article
Oncology
Victoria Kate Marshall, Melody Chavez, Andrea Efre, Paige W. Lake, Khary K. Rigg, Barbara Lubrano, Smitha Pabbathi, Sahana Rajasekhara, Dina Martinez Tyson
Summary: This study explored barriers to pain management and perceptions of opioid use among cancer survivors. The findings revealed that barriers to pain control included self-medicating behaviors and nonadherence to prescribed regimen, lack of insurance coverage and costly alternative pain treatment options, and inadequate addressing and mismanagement of cancer-related chronic pain. The implications for practice are to provide improved access to multimodal pain management options and nonopioid alternatives for cancer survivors, and to support policies and procedures aimed at opioid education, training, and legislation.
