title: Breakthrough Cancer Pain: Preliminary Data of The Italian Oncologic Pain Multisetting Multicentric Survey (IOPS-MS).
abstract: An ongoing national multicenter survey [Italian Oncologic Pain multiSetting Multicentric Survey (IOPS-MS)] is evaluating the characteristics of breakthrough cancer pain (BTP) in different clinical settings. Preliminary data from the first 1500 cancer patients with BTP enrolled in this study are presented here.
  
  
  
  Thirty-two clinical centers are involved in the survey. A diagnosis of BTP was performed by a standard algorithm. Epidemiological data, Karnofsky index, stage of disease, presence and sites of metastases, ongoing oncologic treatment, and characteristics of background pain and BTP and their treatments were recorded. Background pain and BTP intensity were measured. Patients were also questioned about BTP predictability, BTP onset (≤10 or >10 min), BTP duration, background and BTP medications and their doses, time to meaningful pain relief after BTP medication, and satisfaction with BTP medication. The occurrence of adverse reactions was also assessed, as well as mucosal toxicity.
  
  
  
  Background pain was well controlled with opioid treatment (numerical rating scale 3.0 ± 1.1). Patients reported 2.5 ± 1.6 BTP episodes/day with a mean intensity of 7.5 ± 1.4 and duration of 43 ± 40 min; 977 patients (65.1%) reported non-predictable BTP, and 1076 patients (71.7%) reported a rapid onset of BTP (≤10 min). Higher patient satisfaction was reported by patients treated with fast onset opioids.
  
  
  
  These preliminary data underline that the standard algorithm used is a valid tool for a proper diagnosis of BTP in cancer patients. Moreover, rapid relief of pain is crucial for patients' satisfaction. The final IOPS-MS data are necessary to understand relationships between BTP characteristics and other clinical variables in oncologic patients.
  
  
  
  Molteni Farmaceutici, Italy.
authors.affiliation: Anesthesia and Intensive Care and Pain Relief and Supportive Care, La Maddalena Cancer Center, Via San Lorenzo 312, 90146, Palermo, Italy. terapiadeldolore@lamaddalenanet.it.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
authors.affiliation: Molecular and Clinical Medicine, Medical Oncology, La Sapienza University of Rome, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchetti
authors.affiliation: Anesthesiology, Resuscitation, and Pain Therapy Department, National Cancer Institute, IRCCS Foundation Pascale, Naples, Italy.
authors.forename: Arturo
authors.initials: A
authors.lastname: Cuomo
authors.affiliation: Palliative Care, Pain Therapy and Rehabilitation, National Cancer Institute IRCCS Foundation, Milan, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Caraceni
authors.affiliation: Palliative Care and Pain Therapy Unit, Careggi Hospital, Florence, Italy.
authors.forename: Rocco Domenico
authors.initials: RD
authors.lastname: Mediati
authors.affiliation: Primary Care Unit, ASL RM1, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mammucari
authors.affiliation: Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.|Department of Emergency, Admission and Critical Area, Policlinic of Tor Vergata, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Natoli
authors.affiliation: Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.|Department of Emergency, Admission and Critical Area, Policlinic of Tor Vergata, Rome, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Lazzari
authors.affiliation: Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.|Department of Emergency, Admission and Critical Area, Policlinic of Tor Vergata, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Dauri
authors.affiliation: 2nd Medical Oncology Division, Città della Salute e della Scienza Hospital of Turin, Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Airoldi
authors.affiliation: Medical Specialties Department, Oncology and Oncologic Hematology, ASL 13 Mirano, Venice, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Azzarello
authors.affiliation: Medical Oncology Unit, Ospedale di Circolo e Fondazione Macchi Hospital, Varese, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Bandera
authors.affiliation: Medical Oncology Unit, ARNAS Ospedale Civico, Di Cristina, Benfratelli, Palermo, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Blasi
authors.affiliation: Medical Oncology, A.O.R.N. Cardarelli, Naples, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Cartenì
authors.affiliation: Medical Oncology, A.O.R.N. Cardarelli, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Chiurazzi
authors.affiliation: Palliative Care Unit, SAMO ONLUS, Catania, Italy.
authors.forename: Benedetta Veruska Pierpaola
authors.initials: BVP
authors.lastname: Costanzo
authors.affiliation: Palliative Care Unit, ASLAL, Casale Monferrato, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Degiovanni
authors.affiliation: Palliative Care Unit, Department of Primary and Community Care, ASL3 Genovese, Genoa, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Fusco
authors.affiliation: Palliative Care and Pain Therapy Unit, European Oncology Institute IRCCS, Milan, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Guardamagna
authors.affiliation: Abdominal Medical Oncology, National Cancer Institute, IRCCS Foundation Pascale, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Iaffaioli
authors.affiliation: Palliative Care and Pain Therapy Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors.forename: Simeone
authors.initials: S
authors.lastname: Liguori
authors.affiliation: Medical Oncology Unit, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Lorusso
authors.affiliation: Pain Therapy Unit, "A. Businco" Hospital, ASL 8, Cagliari, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Mameli
authors.affiliation: Medical Oncology Unit, S. Croce Hospital, Fano, Pesaro, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Mattioli
authors.affiliation: Section of Clinical Pharmacology and Oncology, Department of Health Sciences, University of Florence, Florence, Italy.
authors.forename: Teresita
authors.initials: T
authors.lastname: Mazzei
authors.affiliation: Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy.
authors.forename: Rita Maria
authors.initials: RM
authors.lastname: Melotti
authors.affiliation: Pain Therapy, S. Croce e Carle, Hospital Cuneo, Cuneo, Italy.
authors.forename: Valentino
authors.initials: V
authors.lastname: Menardo
authors.affiliation: Palliative Care Unit, Salvatore Maugeri-IRCCS Foundation, Pavia, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Miotti
authors.affiliation: Medical Oncology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Moroso
authors.affiliation: Palliative Care and Oncologic Pain Service, S. Camillo-Forlanini Hospital, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: De Santis
authors.affiliation: Pain Medicine Unit, S. Camillo-Forlanini Hospital, Rome, Italy.
authors.forename: Remo
authors.initials: R
authors.lastname: Orsetti
authors.affiliation: Pain Relief, A.O. Dei Colli, Monaldi Hospital, Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Papa
authors.affiliation: Division of Medical Oncology, Department of Oncology, S. Chiara University Hospital, Pisa, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Ricci
authors.affiliation: Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.|Department of Emergency, Admission and Critical Area, Policlinic of Tor Vergata, Rome, Italy.
authors.forename: Alessandro Fabrizio
authors.initials: AF
authors.lastname: Sabato
authors.affiliation: Medical Oncology, Castelfranco Veneto Hospital, Treviso, Italy.
authors.forename: Elvira
authors.initials: E
authors.lastname: Scelzi
authors.affiliation: Department of Palliative Care with Hospice and Pain Therapy Unit, "G.Salvini" Hospital, Garbagnate Milanese, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Sofia
authors.affiliation: Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tonini
authors.affiliation: Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Aielli
authors.affiliation: Palliative Care, FARO Foundation, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Valle
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059390:Breakthrough Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D000072716:Cancer Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid
keywords: Breakthrough pain; Cancer pain; Pain assessment; Rapid-onset opioid