Randomized trial of low-dose morphine versus weak opioids in moderate cancer pain

Elena Bandieri, Marilena Romero, Carla Ida Ripamonti, Fabrizio Artioli, Daniela Sichetti, Caterina Fanizza, Daniele Santini, Luigi Cavanna, Barbara Melotti, Pier Franco Conte, Fausto Roila, Stefano Cascinu, Eduardo Bruera, Gianni Tognoni, Mario Luppi

Research output: Contribution to journalArticlepeer-review


Purpose: The WHO guidelines on cancer pain management recommend a sequential three-step analgesic ladder. However, conclusive data are lacking as to whether moderate pain should be treated with either step II weak opioids or low-dose step III strong opioids. Patients and Methods: In a multicenter, 28-day, open-label randomized controlled study, adults with moderate cancer pain were assigned to receive either a weak opioid or low-dose morphine. The primary outcome was the number of responder patients, defined as patientswith a 20% reduction in pain intensity on the numerical rating scale. Results: A total of 240 patients with cancer (118 in the low-dose morphine and 122 in the weak-opioid group) were included in the study. The primary outcome occurred in 88.2% of the low-dose morphine and in 57.7% of the weak-opioid group (odds risk, 6.18; 95% CI, 3.12 to 12.24; P 30%) and highly meaningful (> 50%) pain reduction from baseline was significantly higher in the low-dose morphine group (P

Original languageEnglish
Pages (from-to)436-442
Number of pages7
JournalJournal of Clinical Oncology
Issue number5
Publication statusPublished - Feb 10 2016

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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