Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster session 10

1479P - Use of rescue opioids and pain control after ketamine initiation in refractory cancer pain: A multicentric observational study

Date

14 Sep 2024

Session

Poster session 10

Topics

Supportive Care and Symptom Management

Tumour Site

Presenters

Pablo Gallardo Melo

Citation

Annals of Oncology (2024) 35 (suppl_2): S913-S922. 10.1016/annonc/annonc1604

Authors

P. Gallardo Melo1, F. Bosma2, A. Urueña3, J. Garrillo Cepeda3, J. Aguilar-Company3, J.C. Tapia4, J. Serna i Mont-Ros3, L. Maciel Bravo5, B. Martin Cullell2, O. Mirallas1, C. Gianella Blanco5, C. Salva de Torres3, S. Martinez Peralta2, M. Aguado Sorolla2, B. Alonso Martínez3, S. Eremiev6, M. Roca3, S. Serradell3, J.C. Galceran3, P. Gomez Pardo1

Author affiliations

  • 1 Oncology Department, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 2 Medical Oncology Dept., Hospital de la Santa Creu i Sant Pau, 08025 - Barcelona/ES
  • 3 Oncology Department, Vall d'Hebron University Hospital, 8035 - Barcelona/ES
  • 4 Medical Oncology Department, Velindre Cancer Centre - Velindre NHS University Trust - NHS Wales, CF14 2TL - Cardiff/GB
  • 5 Palliative Care Department, Parc Sanitari Pere Virgili, 08023 - Barcelona/ES
  • 6 Oncology Department, Vall d'Hebron University Hospital, 08023 - Barcelona/ES

Resources

Login to get immediate access to this content.

If you do not have an ESMO account, please create one for free.

Abstract 1479P

Background

Refractory cancer pain (RCP) affects 10-20% of cancer patients, exhibiting limited response to standard opioids (OPI). Ketamine (KET), an anesthetic medication, has gained recent attention for its potential in managing RCP. This study aims to describe the consumption of rescue OPI before and after initiating KET, the rate of patients meeting a controlled pain criteria, and its safety profile.

Methods

A prospective observational study was conducted in three academic hospitals. Over an 18-month period, we included all cancer patients who initiated KET therapy based on the criteria of their treating medical team. The frequency of OPI rescues was recorded on days five (D-5) and two (D-2), and on days two (D+2) and five (D+5) pre and post KET initiation, respectively. Controlled pain criteria were defined as a 72-hour interval with no more than 3 OPI rescues per day, absence of breakthrough pain, and no escalation in OPI dosage. All adverse effects (AEs) were recorded in accordance with the CTCAE 5.0 guidelines.

Results

Fifty-two patients were included, and their characteristics are described in the table. The most common initiation dose of KET was 0.5 mg/kg/day orally (71.2%). Median oral morphine milligram equivalent (MME) at initiation of KET was 120mg. Overall survival from the onset of KET therapy was 43 days. Median daily OPI rescue was 3.90 on D-5 and 4.62 on D-2, decreasing to 2.79 on D+2 and 2.77 on D+5 (p=

Conclusions

A significant decrease in rescue opioids usage was observed after initiating ketamine. Over 60% of the patients met the criteria for controlled pain, with a favorable safety profile. Further comparative studies are required to better understand the role of ketamine in cancer pain.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Vall d'Hebron University Hospital.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.