• Marte Grønlie Cameron and Christian Kersten.
• Center for Cancer Treatment, Sørlandet Hospital Trust, Kristiansand, Norway.
• Palliat Med. 2022 Jul 1; 36 (7): 1154-1162.

BackgroundNovel treatments of neuropathic pain are urgently needed. Rapid relief of neuropathic cancer pain in patients treated with epidermal growth factor receptor (EGFR) inhibitors have been reported. Experiments in rodent models confirm the pain relief and reveal novel mechanisms critically involving the EGFR. Clinical pain research is complicated and patients with advanced cancer are heterogeneous, often with complex, deteriorating clinical pictures, hampering feasibility of drug-trial procedures.Actual CaseProspective case series exploring the EGFR inhibition/neuropathic cancer pain association in order to inform planning clinical trials.Possible Courses Of ActionSymptom assessment method was tailored to what was ethical, feasible, and clinically relevant for each patient.Formulation Of A PlanPatients with neuropathic cancer pain treated off-label with the monoclonal antibody panitumumab were studied to assess feasibility of different measurement tools.OutcomeFourteen of 20 patients (70%) experienced clinically significant pain relief. There was good concordance in patient and physician-reported outcomes.LessonsResults support panitumumab's potential to be of significant benefit to patients with refractory neuropathic cancer pain. Findings also reinforce the difficulty of using conventional drug trial endpoints and designs in this population.ViewInnovative research methods must be considered for much needed pivotal trials.

16 keywords...

hide…