SAFETY AND EFFECTIVENESS OF TARGETED DRUG DELIVERY (TDD) FOR CANCER PAIN MANAGEMENT: RESULTS FROM THE PRODUCT SURVEILLANCE REGISTRY (PSR)

Introduction. Some patients with head and neck cancers have pain refractory to aggressive multimodal therapies. Herein, we report the use of an intrathecal targeted drug delivery (TDD) system catheter tip placed at C1 for the treatment of recalcitrant oropharyngeal cancer pain. Case Report. A patient with recurrent metastatic squamous cell tongue cancer reported severe pain not controlled despite high-dose opioids and nonopioid adjuvants. It was elected to proceed with an intrathecal TDD system with the catheter tip placed at the C1 level. After pump placement, we were able to decrease her daily oral morphine equivalents (OME) from nearly 1000 mg to 300 mg over the course of two months while titrating her TDD from 0.3 mg/day to 0.7 mg/day of intrathecal hydromorphone. Unfortunately, her improvement was limited secondary to aggressive cancer-directed treatments likely contributing to device infection and explant. Conclusions. In this patient, high cervical placement of an intrathecal TDD catheter was associated with a decrease in OME. While used in clinical practice on occasion, the use of high cervical TDD placement such as this implantable C1 intrathecal TDD system for cancer-associated pain is underreported in the literature. Further studies on this intervention within this challenging population are warranted.

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Cancer Pain Management and Drug Delivery

Drug Delivery in Cancer Treatment ◽

10.1007/978-3-642-73077-1_2 ◽

1987 ◽

pp. 3-17 ◽

Cited By ~ 3

Author(s):

V. Ventafridda ◽

A. Sbanotto ◽

E. Spoldi ◽

A. Caraceni ◽

F. De Conno

Keyword(s):

Drug Delivery ◽

Pain Management ◽

Cancer Pain ◽

Cancer Pain Management

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From Cancer Treatment to Cancer Survivorship: A Case Report Demonstrating the Dynamic Roles of Intrathecal Drug Delivery System in Various Phases of Cancer Care

Pain Management Case Reports ◽

10.36076/pmcr.2020/4/131 ◽

2020 ◽

pp. 131-134

Author(s):

Po-Yi Paul Su

Keyword(s):

Drug Delivery ◽

Case Report ◽

Pain Management ◽

Cancer Pain ◽

Drug Delivery System ◽

Cancer Care ◽

Drug Delivery Systems ◽

Opioid Therapy ◽

Cancer Pain Management ◽

Intrathecal Drug Delivery

Background: Until the continued improvements in cancer diagnosis and treatment, many cancers were once considered terminal illnesses. Opioid-based therapy is frequently utilized from the armamentarium for cancer pain treatment since the immediate goals of acute cancer pain management are focused on alleviating pain severity and improving quality of life during this limited time – despite the risks of chronic opioid therapy. However, now, with an expanding cancer survivor population, we lack guidance and tools to assist health care providers and patients in pivoting the focus of cancer pain management from acute relief toward improving function, rehabilitation, and limiting the long-term adverse effects of pain and opioid therapy. Case Report: Here, we present a case exemplifying the ability of intrathecal drug delivery systems to serve a multitude of roles during the various phases of cancer care: from treating acute cancer-related pain, acting as a tool to wean systemic opioid therapy, to being clinically dormant in situ but ready to serve again in the event of cancer recurrence. Conclusion: Intrthecal drug delivery systems are effective tools in managing acute cancer pain and can also be adapted to help manage chronic pain in cancer survivors. Key words: Cancer pain, intrathecal drug delivery system, intrathecal pump, opioid weaning

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Intrathecal Drug Delivery System Trialing for Cancer Pain Management

Essentials of Interventional Cancer Pain Management ◽

10.1007/978-3-319-99684-4_30 ◽

2018 ◽

pp. 273-276

Author(s):

Namrata Khimani ◽

Sanjeet Narang

Keyword(s):

Drug Delivery ◽

Pain Management ◽

Cancer Pain ◽

Drug Delivery System ◽

Delivery System ◽

Cancer Pain Management ◽

Intrathecal Drug Delivery

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Intrathecal Drug Delivery System (IDDS) for Cancer Pain Management

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909111426134 ◽

2011 ◽

Vol 29 (5) ◽

pp. 388-398 ◽

Cited By ~ 17

Author(s):

Surjya Prasad Upadhyay ◽

Piyush N. Mallick

Keyword(s):

Drug Delivery ◽

Pain Management ◽

Cancer Pain ◽

Drug Delivery System ◽

Delivery System ◽

Cancer Pain Management ◽

Patients With Cancer ◽

Intrathecal Drug Delivery ◽

Number Of Patients ◽

Interventional Pain Management

Cancer pain remains undertreated and a significant number of patients with cancer pain die from severe untreated pain. With increasing survival rate in cancer, the prevalence of cancer pain is also increasing in number. Though majority of patients with cancer pain can be effectively treated with conventional medical management, still a significant portion of patients required some form of interventional pain management techniques. Among the interventional techniques, intrathecal drug delivery is increasingly used in cancer pain management. Our objective of this article is to review literatures and clinical studies on intrathecal drug delivery system (IDDS) in cancer pain management and to provide updates on its use, precautions, contraindications, side effects and its management, socioeconomic consideration, and management of IDDS in difficult or uncommon situations.

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