title: Reconstructing analgesic trials:  reasons for following the lead of oncologists.
abstract: OBJECTIVE
  Changes in drug trial designs in oncology, which involve targeted therapies and well genotyped cancers have important implications to the present trial designs used for analgesic development.
  
  
  RESULTS
  Pain phenotypes influence analgesic responses. Analgesics can now be targeted to pain phenotypes. IMMPACT strategies should be modified using pharmacokinetic-pharmacodynamics and phase II-III trial designs commonly used in oncology.
  
  
  CONCLUSIONS
  Modifying analgesic trial designs will facilitate the development of targeted analgesics and improve the 'signal-to-noise' ratio over present analgesic trial strategies, which are largely based on pain severity and changes in pain intensity over time.
authors.affiliation: Clinical Fellowship Program, Division of Solid Tumor, Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, Palliative Medicine and Supportive Oncology Services, Cleveland Clinic, Cleveland, Ohio, USA. davism6@ccf.org
authors.forename: Mellar P
authors.initials: MP
authors.lastname: Davis
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Mitchell
mesh_terms: D000700:Analgesics / Q000493:pharmacokinetics / Q000494:pharmacology*; D015195:Drug Design; D004341:Drug Evaluation; D006801:Humans; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy*; D012107:Research Design
chemical_list: D000700:Analgesics