Prediction of interindividual variations in pain relief and adverse effects of opioid analgesics based on cancer disease stage

Research Project

Project/Area Number	15K08070
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Medical pharmacy
Research Institution	Hamamatsu University School of Medicine
Principal Investigator	Kawakami Junichi 浜松医科大学, 医学部附属病院, 教授 (50272539)
Co-Investigator(Kenkyū-buntansha)	内藤隆文浜松医科大学, 医学部附属病院, 特任准教授 (80422749)
Research Collaborator	ISHIDA Takuya 浜松医科大学, 医学部附属病院, 薬剤師 TANAKA Hironari 浜松医科大学, 医学部附属病院, 薬剤師
Project Period (FY)	2015-04-01 – 2018-03-31
Project Status	Completed (Fiscal Year 2017)
Budget Amount *help	¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000) Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000) Fiscal Year 2016: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000) Fiscal Year 2015: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Keywords	がん病期 / オピオイド / 炎症性サイトカイン / 薬物動態 / 有害作用 / 鎮痛効果 / がん性疼痛 / 病期 / トラマドール / 薬物代謝 / 忍容性 / フェンタニル / 鎮痛補助薬 / プレガバリン / がん悪液質
Outline of Final Research Achievements	Cancer patients have a large variation in clinical responses to opioid analgesics at each cancer disease stage. Plasma exposure of and clinical responses to opioid analgesics are potentially influenced by the genetic factors including genetic variants of drug metabolizing enzyme and non-genetic factors including gender and physiological changes accompanied with cancer progression. This study evaluated the relationships between the plasma exposure of and clinical responses to opioid analgesics including transdermal fentanyl and oral tramadol, drug tolerance, and adverse effects at each cancer disease stage. In this study, the cancer disease stages employed the serum inflammation markers including IL-6 and CRP, and cancer symptom- and inflammation-based scores. From the cross-sectional analyses for cancer patients, this study revealed the interindividual factors related to the pharmacokinetics of opioid analgesics, pain relief, and adverse effects based on cancer disease stages.