Treating breakthrough pain in oncology

Expert Review of Anticancer Therapy
Sebastiano Mercadante

Abstract

Breakthrough cancer pain (BTcP) is an episode of severe intensity in patients receiving an adequate treatment with opioids able to provide at least mild analgesia. BTcP is a heterogeneous condition as episodes vary between individuals. The aim of this article is to review the pharmacologic options for the management of BTcP. Areas covered: Recent reviews revealed that transmucosal preparations of fentanyl provided superior and more rapid pain relief as compared to placebo and oral morphine within the first 30 min after dosing. Few comparison studies among fentanyl products have been performed. Although dose titration has been recommended for years, a meaningful dosing, according to the level of opioid tolerance, may enhance the advantages of such products Expert commentary: BTcP represents a relevant problem reported by many cancer patients despite receiving regular use of opioids. Different modalities of pharmacological interventions are available. In comparison with oral opioids, fentanyl preparations appear to have a short onset and offset of analgesic effect, fitting the temporal characteristics of BTcP. Further studies are warranted to assess the net benefit of these drugs to assist decision-making by patients, clinicians,...Continue Reading

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Citations

Feb 1, 2020·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·C Camps HerreroV Guillem Porta
Jan 14, 2022·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Yong LiuXiaomao Wang

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