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.
Resources from the same session
1607P - Association of the lipid biomarker, PCPro, and clinical outcomes in the ENZAMET trial (ANZUP 1304)
Presenter: Lisa Horvath
Session: Poster session 10
1608P - Prostate cancer working group 4 (PCWG4) preliminary criteria using serial PSMA PET/CT for response evaluation: Analysis from the PRINCE trial
Presenter: Michael Hofman
Session: Poster session 10
1609P - PSMA-PET and PROMISE re-define stage and risk in patients with prostate cancer
Presenter: Wolfgang Fendler
Session: Poster session 10
1610P - Circulating tumour cell (CTC) enumeration and overall survival (OS) in men with metastatic castration-resistant prostate cancer (mCRPC) treated with xaluritamig
Presenter: Andrew Armstrong
Session: Poster session 10
1611P - Haematologic impact of [177Lu]Lu-PSMA-617 versus ARPI change in patients with metastatic castration-resistant prostate cancer in PSMAfore
Presenter: Kim Nguyen Chi
Session: Poster session 10
1612P - Impact of FANCA, ATM, CDK12 alterations on survival in metastatic castration-resistant prostate cancer (mCRPC)
Presenter: David Lorente
Session: Poster session 10
1613P - Clinically advanced prostate cancer (CAPC) featuring BRCA2 loss: A comprehensive genomic profiling (CGP) study
Presenter: Chiara Mercinelli
Session: Poster session 10
1614P - PSA responses and PSMA scan changes after immunotherapy for biochemically recurrent prostate cancer (BCR) without androgen deprivation therapy (ADT)
Presenter: Ravi Madan
Session: Poster session 10
1615P - A new prognostic model of overall survival (OS) in patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC)
Presenter: Susan Halabi
Session: Poster session 10