Phase II trial of oxycodone in the treatment of refractory dyspnea in advanced breast cancer patients. Abst. ID: 115 (Temp. Abst. ID: 54857) Local/Regional Therapy Authors: R. Trujillo, C. Nuño, I. Fortes
Dyspnea is a frequent symptom in breast advanced cancer patients, and may seriously affect patient quality of life. Oxycodone (14-hydroxy-7 ,8-dihdrocodeinone) is a semisynthetic product derived from an alkaloid of opium, is a pure agonist of receptors mu and kappa. It is indicated for the treatment of severe pain, however its use for treatment of dyspnea has been little studied, when being an opioid similar to morphine, efficacy in the treatment of dyspnea should at least be similar to the morphine . BACKGROUND
METHODS We designed a phase II trial to evaluate the efficacy and safety of oxycodone in breast advanced cancer patients experiencing dyspnea. Eligible criteria were: patients older than 18 years of age with satisfactory baseline cognitive function diagnosed with end-stage breast cancer complaining of dyspnea. The study was conducted on a total of 20 breast cancer patients with dyspnea advanced disease refractory to treatment with corticosteroids and subsidiary of treatment with morphine. Visual analogue scale was used to score VAS 1 (less dyspnea) -10 (worst dyspnea) before treatment with oxycodone and one month after treatment.
RESULTS The average age of patients was 59.5 years. The most common side effects were constipation in 20%, nausea and vomiting in 10% of patients. There were no patient abandoned treatment because of side effects. The average time treated with oral oxycodone was 75.5 days. The average initial dose was 10 mg/day and the mean final dose of 30 mg/day. The average initial VAS was 7.5, and mean final VAS was 1.6, and this difference was statistically significant (p 0.005) in favor of improvement of dyspnea with oxycodone.
CONCLUSIONS The results obtained in this phase II study confirms that the oxycodone is effective and safe for control of dyspnea in breast cancer patients with advanced disease refractory dyspnea, and should be studied and compared in a phase III trial to morphine, which is currently the standard.