• Timothy R Deer, Salim M Hayek, Jay S Grider, Jason E Pope, Shane E Brogan, Amitabh Gulati, Jonathan M Hagedorn, Natalie Strand, Jennifer Hah, Tony L Yaksh, Peter S Staats, Christophe Perruchoud, Nebojsa Nick Knezevic, Mark S Wallace, Julie G Pilitsis, Tim J Lamer, Eric Buchser, Vishal Varshney, Jill Osborn, Vasudha Goel, Brian A Simpson, Jose A Lopez, Denis Dupoiron, Michael F Saulino, Gladstone C McDowell, Fabian Piedimonte, and Robert M Levy.
• The Spine and Nerve Center of the Virginias, Charleston, WV, USA. Electronic address: doctdeer@aol.com.
• Neuromodulation. 2024 Sep 20.

IntroductionThe International Neuromodulation Society convened a multispecialty group of physicians based on expertise with international representation to establish evidence-based guidance on using intrathecal drug delivery in chronic pain treatment. This Polyanalgesic Consensus Conference (PACC)® project's scope is to provide evidence-based guidance for clinical pharmacology and best practices for intrathecal drug delivery for cancer pain.Materials And MethodsAuthors were chosen on the basis of their clinical expertise, familiarity with the peer-reviewed literature, research productivity, and contributions to the neuromodulation literature. Section leaders supervised literature searches using Medline, EMBASE, Cochrane CENTRAL, BioMed Central, Web of Science, Google Scholar, PubMed, Current Contents Connect, Meeting Abstracts, and Scopus from 2017 (when the PACC last published guidelines) to the present. Identified studies were graded using the United States Preventive Services Task Force criteria for evidence and certainty of net benefit. Recommendations were based on the strength of evidence, and when evidence was scant, recommendations were based on expert consensus.ResultsThe PACC evaluated the published literature and established evidence- and consensus-based expert opinion recommendations to guide best practices in treating cancer pain. Additional guidance will occur as new evidence is developed in future iterations of this process.ConclusionsThe PACC recommends best practices regarding the use of intrathecal drug delivery in cancer pain, with an emphasis on managing the unique disease and patient characteristics encountered in oncology. These evidence- and consensus-based expert opinion recommendations should be used as a guide to assist decision-making when clinically appropriate.Copyright © 2024 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.

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