Breakthrough Cancer Pain: Preliminary Data of The Italian Oncologic Pain Multisetting Multicentric Survey (IOPS-MS)

Sebastiano Mercadante, Paolo Marchetti, Arturo Cuomo, Augusto Caraceni, Rocco Domenico Mediati, Massimo Mammucari, Silvia Natoli, Marzia Lazzari, Mario Dauri, Mario Airoldi, Giuseppe Azzarello, Mauro Bandera, Livio Blasi, Giacomo Cartenì, Bruno Chiurazzi, Benedetta Veruska Pierpaola Costanzo, Daniela Degiovanni, Flavio Fusco, Vittorio Guardamagna, Vincenzo IaffaioliSimeone Liguori, Vito Lorusso, Sergio Mameli, Rodolfo Mattioli, Teresita Mazzei, Rita Maria Melotti, Valentino Menardo, Danilo Miotti, Stefano Moroso, Stefano De Santis, Remo Orsetti, Alfonso Papa, Sergio Ricci, Alessandro Fabrizio Sabato, Elvira Scelzi, Michele Sofia, Giuseppe Tonini, Federica Aielli, Alessandro Valle, IOPS MS study group

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: An ongoing national multicenter survey [Italian Oncologic Pain multiSetting Multicentric Survey (IOPS-MS)] is evaluating the characteristics of breakthrough cancer pain (BTP) in different clinical settings. Preliminary data from the first 1500 cancer patients with BTP enrolled in this study are presented here.

METHODS: Thirty-two clinical centers are involved in the survey. A diagnosis of BTP was performed by a standard algorithm. Epidemiological data, Karnofsky index, stage of disease, presence and sites of metastases, ongoing oncologic treatment, and characteristics of background pain and BTP and their treatments were recorded. Background pain and BTP intensity were measured. Patients were also questioned about BTP predictability, BTP onset (≤10 or >10 min), BTP duration, background and BTP medications and their doses, time to meaningful pain relief after BTP medication, and satisfaction with BTP medication. The occurrence of adverse reactions was also assessed, as well as mucosal toxicity.

RESULTS: Background pain was well controlled with opioid treatment (numerical rating scale 3.0 ± 1.1). Patients reported 2.5 ± 1.6 BTP episodes/day with a mean intensity of 7.5 ± 1.4 and duration of 43 ± 40 min; 977 patients (65.1%) reported non-predictable BTP, and 1076 patients (71.7%) reported a rapid onset of BTP (≤10 min). Higher patient satisfaction was reported by patients treated with fast onset opioids.

CONCLUSIONS: These preliminary data underline that the standard algorithm used is a valid tool for a proper diagnosis of BTP in cancer patients. Moreover, rapid relief of pain is crucial for patients' satisfaction. The final IOPS-MS data are necessary to understand relationships between BTP characteristics and other clinical variables in oncologic patients.

FUNDING: Molteni Farmaceutici, Italy.

Original languageEnglish
Pages (from-to)120-135
Number of pages16
JournalAdvances in Therapy
Issue number1
Publication statusPublished - Jan 2017


  • Journal Article


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