title: Clinical and genetic factors related to cancer-induced bone pain and bone pain relief.
abstract: OBJECTIVE
  The study objective was to evaluate whether there are clinical or genetic differences between patients with cancer-induced bone pain (CIBP) and patients with non-CIBP, and, in the CIBP group, in those with good versus poor opioid response.
  
  
  METHODS
  A total of 2,294 adult patients with cancer who were receiving opioids for moderate or severe pain were included in the European Pharmacogenetic Opioid Study. Pain intensity and pain relief were measured using the Brief Pain Inventory. Linkage disequilibrium of 112 single nucleotide polymorphisms was evaluated in 25 candidate genes, and 43 haplotypes were assessed. Correlations among demographical factors, disease-related factors, genetic factors, CIBP, and pain relief were analyzed by logistic regression models corrected for multiple testing. Patients with bone metastases and bone/soft tissue pain were defined as having prevalent bone pain (CIBP population). This population was compared with patients who had other types of cancer pain (non-CIBP).
  
  
  RESULTS
  A total of 577 patients (26.2%) had CIBP, and 1,624 patients (73.8%) had non-CIBP. Patients with CIBP had more breakthrough cancer pain episodes (64.2% vs. 56.4%, p = .001), had significantly higher pain interference in "walking ability in the past 24 hours" (p < .0001), used more adjuvant drugs (84.1% vs. 78.3%, p = .003), and had a higher, albeit nonsignificant, median overall survival (3.8 vs. 2.9 months, p = .716) than patients with non-CIBP. None of the examined haplotypes exceeded p values corrected for multiple testing for the investigated outcomes.
  
  
  CONCLUSIONS
  Patients with CIBP who were taking opioids had a clinical profile slightly different from that of the non-CIBP group. However, no specific genetic pattern emerged for CIBP versus non-CIBP or for responsive versus nonresponsive patients with CIBP.
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Scarpi
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Daniele
authors.initials: D
authors.lastname: Calistri
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Pål
authors.initials: P
authors.lastname: Klepstad
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Stein
authors.initials: S
authors.lastname: Kaasa
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Frank
authors.initials: F
authors.lastname: Skorpen
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Habberstad
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Oriana
authors.initials: O
authors.lastname: Nanni
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
authors.affiliation: Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway ma.maltoni@ausl.fo.it malto.ma@tin.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Maltoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000235:genetics* / Q000556:secondary*; D003430:Cross-Sectional Studies; D005260:Female; D006239:Haplotypes; D006801:Humans; D015810:Linkage Disequilibrium; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D059408:Pain Management; D010147:Pain Measurement; D010148:Intractable Pain / Q000188:drug therapy* / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D011788:Quality of Life; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid
keywords: Assessment; Cancer-induced bone pain; Genetic factors; Haplotypes; Opioids; Palliative care