title: Opioid treatment failure in cancer patients: the role of clinical and genetic factors.
abstract: To identify clinical and genetic factors associated with outcome of opioid treatment.
  
  
  
  We performed an exploratory analysis in a cohort of 353 patients treated with fentanyl, morphine, oxycodone and/or hydromorphone for cancer-related pain, exploring selected clinical and pharmacogenetic factors for a correlation with treatment failure for all and per type of opioid.
  
  
  
  Use of adjuvant pain medication, intensity of pain at rest and age were associated with treatment failure in the various cohorts. Only the genetic variants rs12948783 (RHBDF2) and rs7016778 (OPRK1) correlated statistically significant in univariate, but not in multivariable analysis.
  
  
  
  Several clinical and genetic factors were identified that warrant further study to clarify their role and use in opioid treatment.
authors.affiliation: Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Astrid W
authors.initials: AW
authors.lastname: Oosten
authors.affiliation: Department of Clinical Chemistry, Erasmus MC, Rotterdam, The Netherlands.|Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Maja
authors.initials: M
authors.lastname: Matic
authors.affiliation: Department of Clinical Chemistry, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Ron H
authors.initials: RH
authors.lastname: van Schaik
authors.affiliation: Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Maxime P
authors.initials: MP
authors.lastname: Look
authors.affiliation: Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Joost L
authors.initials: JL
authors.lastname: Jongen
authors.affiliation: Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Ron H
authors.initials: RH
authors.lastname: Mathijssen
authors.affiliation: Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.|Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
authors.forename: Carin C
authors.initials: CC
authors.lastname: van der Rijt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000072716:Cancer Pain / Q000188:drug therapy* / Q000235:genetics*; D015331:Cohort Studies; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010597:Pharmacogenetics; D020641:Polymorphism, Single Nucleotide; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: SNPs; analgesics; cancer pain; fentanyl; morphine; opioid rotation; opioids; oxycodone; treatment failure