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Review
. 2021 Feb 26;22(3):26.
doi: 10.1007/s11864-021-00816-5.

Insights into the Use of Peripherally Acting μ-Opioid Receptor Antagonists (PAMORAs) in Oncologic Patients: from Scientific Evidence to Real Clinical Practice

Ana Fernández-Montes  1 , Guillermo de Velasco  2 , Santiago Aguín  3 , Cristina Farriols  4 , María Guirado-Risueño  5 , Vanessa G Jerviz-Guía  6 , María Victoria Baeza-Nadal  7 , Rodolfo Chicas-Sett  8 , José Luis Fírvida  9 , Francisco García-Navalón  10 , Patricia Martín  11 , Carmen Perezagua-Marín  12 , Dulce Rodríguez  13 , Joan Santamaría  14 , Tamara Saurí  15   16 , Manuel Cobo  17
Affiliations
Review

Insights into the Use of Peripherally Acting μ-Opioid Receptor Antagonists (PAMORAs) in Oncologic Patients: from Scientific Evidence to Real Clinical Practice

Ana Fernández-Montes et al. Curr Treat Options Oncol. .

Abstract

Management of chronic pain is crucial to improve the quality of life of cancer and palliative care patients. Opioid-based treatments used to control pain can be prolonged over time. Unfortunately, constipation is one of the most disturbing adverse effects of long-term use of opioids. Opioid-induced constipation (OIC) occurs when opioids bind to the specific receptors present in the gastrointestinal (GI) tract, and can affect any patients receiving chronic opioid therapy, including cancer patients. The limited efficacy of laxatives to treat OIC symptoms prompted the search for new therapeutic strategies. Peripherally acting μ-opioid receptor antagonists (PAMORAs) have recently emerged as new effective drugs for OIC management due to their specific binding to enteric μ-receptors. Little information is available on the use of PAMORAs in real-life practice for OIC treatment in cancer patients. In this paper, a panel of experts specializing in cancer and palliative care pools their clinical experience with PAMORAs in cancer patients presenting OIC and highlights the importance of timing and choice of therapy in achieving prompt OIC management and benefitting patients.

Keywords: Cancer; Laxatives; Opioid analgesics; Opioid-induced constipation; PAMORA; Pain.

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