{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:51:23Z","timestamp":1790661083158,"version":"4.1.0"},"reference-count":66,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Severe cancer pain substantially affects patients\u2019 quality of life, increasing the burden of the disease and reducing the disability-adjusted life years. Although opioid analgesics are effective, they may induce opioid-induced bowel dysfunction (OIBD). Oxycodone\/naloxone combination therapy has emerged as a promising approach to mitigate opioid-induced constipation (OIC) while providing effective pain relief. This review provides an updated analysis of the literature of the last decade regarding the use of oxycodone\/naloxone in the management of severe cancer pain. Through a comprehensive search of databases, studies focusing on the efficacy, safety, and patient experience of oxycodone\/naloxone\u2019s prolonged release in severe cancer pain management were identified. Furthermore, the literature discusses the mechanism of action of naloxone in mitigating OIC without compromising opioid analgesia. Overall, the evidence suggests that oxycodone\/naloxone combination therapy offers a valuable option for effectively managing severe cancer pain while minimizing opioid-induced constipation, thereby improving patients\u2019 quality of life. However, further research is needed to optimize dosing regimens, evaluate long-term safety, and assess patient outcomes in diverse cancer populations.<\/jats:p>","DOI":"10.3390\/jpm14050483","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T10:33:31Z","timestamp":1714559611000},"page":"483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Managing Severe Cancer Pain with Oxycodone\/Naloxone Treatment: A Literature Review Update"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8081-7480","authenticated-orcid":false,"given":"Paolo","family":"Formenti","sequence":"first","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4356-3543","authenticated-orcid":false,"given":"Michele","family":"Umbrello","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, New Hospital of Legnano (Ospedale Nuovo di Legnano), 20025 Legnano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Pignataro","sequence":"additional","affiliation":[{"name":"Contenuto Ed Net Communications SL, 20131 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Sabbatini","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Dottorini","sequence":"additional","affiliation":[{"name":"Oncology Unit, ASST Bergamo Ovest, 20047 Treviglio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Gotti","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Brenna","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Menozzi","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Terranova","sequence":"additional","affiliation":[{"name":"Anaesthesia and Intensive Care Department, Asst Gaetano Pini, 20100 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Galimberti","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9130-5554","authenticated-orcid":false,"given":"Angelo","family":"Pezzi","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, Cinisello Balsamo, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6838","DOI":"10.3390\/curroncol30070500","article-title":"Cancer Pain Management: A Narrative Review of Current Concepts, Strategies, and Techniques","volume":"30","author":"Mestdagh","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jpainsymman.2005.01.010","article-title":"Oxycodone","volume":"29","author":"Kalso","year":"2005","journal-title":"J. Pain. Symptom Manag."},{"key":"ref_3","unstructured":"Sizar, O., Genova, R., and Gupta, M. (2023). StatPearls, StatPearls Publishing."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/ajgsup.2014.7","article-title":"Opioid-Induced Bowel Dysfunction: Epidemiology, Pathophysiology, Diagnosis, and Initial Therapeutic Approach","volume":"2","author":"Dorn","year":"2014","journal-title":"Am. J. Gastroenterol. Suppl."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1111\/papr.12646","article-title":"Oral Prolonged-Release Oxycodone\/Naloxone for Managing Pain and Opioid-Induced Constipation: A Review of the Evidence","volume":"18","author":"Morlion","year":"2018","journal-title":"Pain. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"124","DOI":"10.2174\/13894501113149990210","article-title":"Oxycodone\/Naloxone in the Management of Patients with Pain and Opioid-Induced Bowel Dysfunction","volume":"15","author":"Leppert","year":"2014","journal-title":"Curr. Drug Targets"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1007\/s40261-017-0593-1","article-title":"Oxycodone\/Naloxone Prolonged Release: A Review in Severe Chronic Pain","volume":"37","author":"Kim","year":"2017","journal-title":"Clin. Drug Investig."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/0304-3959(94)00178-H","article-title":"When Is Cancer Pain Mild, Moderate or Severe? Grading Pain Severity by Its Interference with Function","volume":"61","author":"Serlin","year":"1995","journal-title":"Pain"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Caraceni, A., and Shkodra, M. (2019). Cancer Pain Assessment and Classification. Cancers, 11.","DOI":"10.3390\/cancers11040510"},{"key":"ref_10","unstructured":"Jordan, M.R., and Morrisonponce, D. (2024). StatPearls, StatPearls Publishing."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S0885-3924(01)00369-4","article-title":"Low-Dose Oral Naloxone Reverses Opioid-Induced Constipation and Analgesia","volume":"23","author":"Liu","year":"2002","journal-title":"J. Pain. Symptom Manag."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s40265-014-0177-9","article-title":"Oxycodone\/Naloxone Prolonged-Release: A Review of Its Use in the Management of Chronic Pain While Counteracting Opioid-Induced Constipation","volume":"74","author":"Burness","year":"2014","journal-title":"Drugs"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/ajco.13561","article-title":"Oxycodone\/Naloxone Prolonged-Release Tablets in Patients with Moderate-to-Severe, Chronic Cancer Pain: Challenges in the Context of Hepatic Impairment","volume":"18","author":"Le","year":"2022","journal-title":"Asia Pac. J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Anderson, N.M., and Simon, M.C. (2020). Tumor Microenvironment. Curr. Biol. CB, 30.","DOI":"10.1016\/j.cub.2020.06.081"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1007\/s00418-008-0527-3","article-title":"Tumor-Host Interactions: The Role of Inflammation","volume":"130","author":"Stamenkovic","year":"2008","journal-title":"Histochem. Cell Biol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Nguyen, T.M., Ngoc, D.T.M., Choi, J.-H., and Lee, C.-H. (2023). Unveiling the Neural Environment in Cancer: Exploring the Role of Neural Circuit Players and Potential Therapeutic Strategies. Cells, 12.","DOI":"10.3390\/cells12151996"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Wang, W., Li, L., Chen, N., Niu, C., Li, Z., Hu, J., and Cui, J. (2020). Nerves in the Tumor Microenvironment: Origin and Effects. Front. Cell Dev. Biol., 8.","DOI":"10.3389\/fcell.2020.601738"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"692142","DOI":"10.3389\/fonc.2021.692142","article-title":"Tumor-Induced Inflammatory Cytokines and the Emerging Diagnostic Devices for Cancer Detection and Prognosis","volume":"11","author":"Kartikasari","year":"2021","journal-title":"Front. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1038\/s41392-021-00658-5","article-title":"Inflammation and Tumor Progression: Signaling Pathways and Targeted Intervention","volume":"6","author":"Zhao","year":"2021","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1177\/2049463714545136","article-title":"Cancer Pain Physiology","volume":"8","author":"Falk","year":"2014","journal-title":"Br. J. Pain."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Yam, M.F., Loh, Y.C., Tan, C.S., Khadijah Adam, S., Abdul Manan, N., and Basir, R. (2018). General Pathways of Pain Sensation and the Major Neurotransmitters Involved in Pain Regulation. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19082164"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.jpain.2009.06.012","article-title":"Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity","volume":"10","author":"Latremoliere","year":"2009","journal-title":"J. Pain."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.pain.2010.09.030","article-title":"Central Sensitization: Implications for the Diagnosis and Treatment of Pain","volume":"152","author":"Woolf","year":"2011","journal-title":"Pain"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1030899","DOI":"10.3389\/fpain.2022.1030899","article-title":"Mechanisms of Cancer Pain","volume":"3","author":"Haroun","year":"2023","journal-title":"Front. Pain Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4055","DOI":"10.1002\/cam4.2256","article-title":"What Are the Clinical Symptoms and Physical Signs for Non-small Cell Lung Cancer before Diagnosis Is Made? A Nation-wide Multicenter 10-year Retrospective Study in China","volume":"8","author":"Xing","year":"2019","journal-title":"Cancer Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4043","DOI":"10.2147\/OTT.S108144","article-title":"Analgesic Effectiveness and Tolerability of Oral Oxycodone\/Naloxone and Pregabalin in Patients with Lung Cancer and Neuropathic Pain: An Observational Analysis","volume":"9","author":"Borghesi","year":"2016","journal-title":"Onco Targets Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.2147\/JPR.S141928","article-title":"A Comparison between the Administration of Oral Prolonged-Release Oxycodone-Naloxone and Transdermal Fentanyl in Patients with Moderate-to-Severe Cancer Pain: A Propensity Score Analysis","volume":"10","author":"Roberto","year":"2017","journal-title":"JPR"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1634\/theoncologist.2011-0159","article-title":"Symptom Management in Metastatic Breast Cancer","volume":"16","author":"Irvin","year":"2011","journal-title":"Oncologist"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1177\/1049909113510058","article-title":"Efficacy and Gastrointestinal Tolerability of Oral Oxycodone\/Naloxone Combination for Chronic Pain in Outpatients with Cancer: An Observational Study","volume":"31","author":"Cuomo","year":"2014","journal-title":"Am. J. Hosp. Palliat. Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3573","DOI":"10.1007\/s00520-022-06803-2","article-title":"Colorectal Cancer Pain upon Diagnosis and after Treatment: A Cross-Sectional Comparison with Healthy Matched Controls","volume":"30","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e971","DOI":"10.1002\/onco.13796","article-title":"Pancreas Cancer-Associated Pain Management","volume":"26","author":"Coveler","year":"2021","journal-title":"Oncologist"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"103122","DOI":"10.1016\/j.critrevonc.2020.103122","article-title":"Management of Pain in Colorectal Cancer Patients","volume":"157","author":"Makaro","year":"2021","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/papr.12784","article-title":"Oral Prolonged-Release Oxycodone-Naloxone: Analgesic Response, Safety Profile, and Factors Influencing the Response in Advanced Cancer Patients","volume":"19","author":"Corli","year":"2019","journal-title":"Pain. Pract."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1002\/ejp.1054","article-title":"A Phase III Randomized Controlled Study on the Efficacy and Improved Bowel Function of Prolonged-Release (PR) Oxycodone-Naloxone (up to 160\/80 Mg Daily) vs Oxycodone PR","volume":"21","author":"Dupoiron","year":"2017","journal-title":"Eur. J. Pain."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5863","DOI":"10.2147\/DDDT.S92998","article-title":"Efficacy and Tolerability of Oral Oxycodone and Oxycodone\/Naloxone Combination in Opioid-Na&iuml;ve Cancer Patients: A Propensity Analysis","volume":"9","author":"Lazzari","year":"2015","journal-title":"DDDT"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1007\/s00520-014-2435-5","article-title":"Long-Term Safety and Efficacy of Oxycodone\/Naloxone Prolonged-Release Tablets in Patients with Moderate-to-Severe Chronic Cancer Pain","volume":"23","author":"Ahmedzai","year":"2015","journal-title":"Support. Care Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1177\/0269216311418869","article-title":"A Randomized, Double-Blind, Active-Controlled, Double-Dummy, Parallel-Group Study to Determine the Safety and Efficacy of Oxycodone\/Naloxone Prolonged-Release Tablets in Patients with Moderate\/Severe, Chronic Cancer Pain","volume":"26","author":"Ahmedzai","year":"2012","journal-title":"Palliat. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S1090-3801(98)90020-9","article-title":"Controlled-Release Oxycodone Compared with Controlled-Release Morphine in the Treatment of Cancer Pain: A Randomized, Double-Blind, Parallel-Group Study","volume":"2","author":"Berman","year":"1998","journal-title":"Eur. J. Pain."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3051","DOI":"10.1007\/s00520-017-3709-5","article-title":"High Dosage of a Fixed Combination Oxycodone\/Naloxone Prolonged Release: Efficacy and Tolerability in Patients with Chronic Cancer Pain","volume":"25","author":"Amato","year":"2017","journal-title":"Support. Care Cancer"},{"key":"ref_40","first-page":"1","article-title":"Cancer Pain Therapy with a Fixed Combination of Prolonged-Release Oxycodone\/Naloxone: Results from a Non-Interventional Study","volume":"5","author":"Nolte","year":"2014","journal-title":"Pragmat. Obs. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1111\/j.1742-1241.2011.02634.x","article-title":"Bowel Function during Pain Therapy with Oxycodone\/Naloxone Prolonged-Release Tablets in Patients with Advanced Cancer","volume":"65","author":"Clemens","year":"2011","journal-title":"Int. J. Clin. Pract."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e4729","DOI":"10.1097\/MD.0000000000004729","article-title":"The Effect of Naloxone Treatment on Opioid-Induced Side Effects","volume":"95","author":"He","year":"2016","journal-title":"Medicine"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2147\/CEG.S143913","article-title":"Prolonged-Release Oxycodone\/Naloxone Reduces Opioid-Induced Constipation and Improves Quality of Life in Laxative-Refractory Patients: Results of an Observational Study","volume":"11","author":"Bantel","year":"2018","journal-title":"Clin. Exp. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S1640","DOI":"10.1016\/j.annonc.2023.10.542","article-title":"456P Oxycodone\/Naloxone in Moderate-to-Severe Cancer Pain: A Phase III Study in China","volume":"34","author":"Yu","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"101331","DOI":"10.1016\/j.ssmph.2022.101331","article-title":"US Trends in Social Isolation, Social Engagement, and Companionship\u2014Nationally and by Age, Sex, Race\/Ethnicity, Family Income, and Work Hours, 2003\u20132020","volume":"21","author":"Kannan","year":"2023","journal-title":"SSM -Popul. Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1023\/B:QURE.0000018472.46236.05","article-title":"Health-Related Quality of Life Associated with Chronic Conditions in Eight Countries: Results from the International Quality of Life Assessment (IQOLA) Project","volume":"13","author":"Alonso","year":"2004","journal-title":"Qual. Life Res."},{"key":"ref_47","first-page":"129","article-title":"Pain Assessment: Global Use of the Brief Pain Inventory","volume":"23","author":"Cleeland","year":"1994","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1526-4637.2008.00495.x","article-title":"The Prevalence, Severity, and Impact of Opioid-Induced Bowel Dysfunction: Results of a US and European Patient Survey (PROBE 1)","volume":"10","author":"Bell","year":"2009","journal-title":"Pain. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"11S","DOI":"10.1016\/S0002-9610(01)00782-6","article-title":"Incidence, Prevalence, and Management of Opioid Bowel Dysfunction","volume":"182","author":"Pappagallo","year":"2001","journal-title":"Am. J. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3111\/13696990903584436","article-title":"Quality of Life in Relation to Constipation among Opioid Users","volume":"13","author":"Klok","year":"2010","journal-title":"J. Med. Econ."},{"key":"ref_51","first-page":"CD006332","article-title":"Mu-Opioid Antagonists for Opioid-Induced Bowel Dysfunction in People with Cancer and People Receiving Palliative Care","volume":"9","author":"Candy","year":"2022","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/147323001103900106","article-title":"The Bowel Function Index for Evaluating Constipation in Pain Patients: Definition of a Reference Range for a Non-Constipated Population of Pain Patients","volume":"39","author":"Ueberall","year":"2011","journal-title":"J. Int. Med. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1093\/pm\/pnab010","article-title":"Pain Medication Adherence in Patients with Cancer: A Pragmatic Review","volume":"23","author":"Vanneste","year":"2022","journal-title":"Pain. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/S1526-5900(03)00556-X","article-title":"Americal Pain Society Management of Opioid Side Effects in Cancer-Related and Chronic Noncancer Pain: A Systematic Review","volume":"4","author":"McNicol","year":"2003","journal-title":"J. Pain."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.sjpain.2017.09.009","article-title":"Individual Variability in Clinical Effect and Tolerability of Opioid Analgesics\u2014Importance of Drug Interactions and Pharmacogenetics","volume":"17","author":"Solhaug","year":"2017","journal-title":"Scand. J. Pain."},{"key":"ref_56","first-page":"CD006605","article-title":"Long-Term Opioid Management for Chronic Noncancer Pain","volume":"2010","author":"Noble","year":"2010","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/S0140-6736(19)31276-0","article-title":"Pharmacogenomics","volume":"394","author":"Roden","year":"2019","journal-title":"Lancet"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Bugada, D., Lorini, L.F., Fumagalli, R., and Allegri, M. (2020). Genetics and Opioids: Towards More Appropriate Prescription in Cancer Pain. Cancers, 12.","DOI":"10.3390\/cancers12071951"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1188\/15.ONF.420-422","article-title":"Genetic Variants Influencing Patient Response to Opioid Therapy","volume":"42","author":"Tadje","year":"2015","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1002\/cpt.2149","article-title":"Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy","volume":"110","author":"Crews","year":"2021","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1517\/17425255.2013.779669","article-title":"Contribution of Oxycodone and Its Metabolites to the Overall Analgesic Effect after Oxycodone Administration","volume":"9","author":"Klimas","year":"2013","journal-title":"Expert. Opin. Drug Metab. Toxicol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s00228-011-1093-5","article-title":"Do CYP2D6 Genotypes Reflect Oxycodone Requirements for Cancer Patients Treated for Cancer Pain? A Cross-Sectional Multicentre Study","volume":"68","author":"Andreassen","year":"2012","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/j.1399-6576.2009.02104.x","article-title":"Impact of the CYP2D6 Genotype on Post-Operative Intravenous Oxycodone Analgesia","volume":"54","author":"Zwisler","year":"2010","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"917","DOI":"10.2215\/CJN.05180418","article-title":"Clinical Pharmacology Considerations in Pain Management in Patients with Advanced Kidney Failure","volume":"14","author":"Davison","year":"2019","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"iv166","DOI":"10.1093\/annonc\/mdy152","article-title":"ESMO Guidelines Committee Management of Cancer Pain in Adult Patients: ESMO Clinical Practice Guidelines","volume":"29","author":"Fallon","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11916-017-0607-y","article-title":"Multimodal Analgesia, Current Concepts, and Acute Pain Considerations","volume":"21","author":"Helander","year":"2017","journal-title":"Curr. Pain. Headache Rep."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/5\/483\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:38:25Z","timestamp":1760107105000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/5\/483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,1]]},"references-count":66,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["jpm14050483"],"URL":"https:\/\/doi.org\/10.3390\/jpm14050483","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,1]]}}}