Disclosures ME – None OU – None BB – Consultant for Jazz Pharmaceuticals – Consultant for Medtronic.

Slides:

Advertisements

Similar presentations

Case 20 Thomas J. Giordano, M.D., Ph.D.. History A 54-year old man with a past medical history of goiter for approximately 4 years was followed by ultrasound.

Advertisements

Metoclopramide versus Hydromorphone for the ED Treatment of Migraine Headaches Justin Griffith, MD Mark Mycyk, MD Demetrios Kyriacou, MD, PhD ICEP Resident.

Role of Intrathecal Polyanalgesia- Its Cost Impact and Role in Recapturing Pain Control Dr. Krishna Kumar, M.B., M.S., F.R.C.S. (C), F.A.C.S. Syed Rizvi.

MOSAIC Stage ll+lll FOLFOX4 LV5FU2 Randomize. DFS DFS (months) Hazard ratio: 0.77 [0.65 – 0.92] p < 0.01 FOLFOX (n=1123) 77.9% LV5FU2 (n=1123) 72.8% FOLFOX.

Controversies in Adjuvant Therapy for Pancreatic Cancer Parag Sanghvi M.D. Tasha McDonald M.D. Department of Radiation Medicine OHSU.

Malignant Pain The Role of IDDS Mark Schlesinger, MD Schlesinger Pain Centers

Surgery v Radiation in Prostate Cancer Prasanna Sooriakumaran MD PhD & Peter Wiklund MD PhD.

Neoadjuvant Adjuvant Curative Palliative Neoadjuvant Radiation therapy the results of a phase III study from Beijing demonstrated a survival benefit.

Single Center Experience of Spinal Cord Stimulation in Chronic Abdominal Pain James R. Bruns, MD; Hammam H. Akbik, MD, Harsh Sachdeva, MD Department of.

1Stopeck A et al. Proc SABCS 2010;Abstract P

“Fighting Cancer: It’s All We Do.” ™. Restoring Quality of Life And Managing Side Effects Ulka Vaishampayan M.D. Chair, GU Multidisciplinary team Associate.

Intrathecal Therapies: Local and National Trends and Complications NANS 2010 Nandan Lad, MD, PhD; Robert T. Arrigo, MS; Melanie Hayden,MD; Paul Kalanithi,

Use of the Personal Therapy Manager With Prialt® (Ziconotide Intrathecal Infusion) for Patient-controlled Analgesia: Case Series Gladstone C. McDowell,

Technical Aspects of Percutaneous Vertebroplasty Dr. Cosme Argerich Neurosurgeon.

Novel Therapies and Technologies

Hormone Refractory Prostate Cancer A Regulatory Perspective of End Points to Measure Safety and Efficacy of Drugs Hormone Refractory Prostate Cancer Bhupinder.

 General recommendations -adjuvant systemic therapy :with tamoxifen or multiple-chemotherapy agent :lower the incidence of recurrence by about 30% - in.

Introduction Patients with tumors affecting the spine have significant impairments in Quality of Life domains that include physical function, neural function,

1 ENTEREG ® (Alvimopan) Special Safety Section Marjorie Dannis, M.D. Division of Gastroenterology Products Office of Drug Evaluation III CDER, FDA The.

The treatment of metastatic squamous cell carcinoma (SCCA) of the anal canal: A single institution experience P. Pathak, B. King, A. Ohinata, P. Das, C.H.

Opioid Tolerance and Opioid- Induced Hyperalgesia David J. Clark.

Quality of life results from a Phase III trial of trastuzumab plus chemotherapy in first-line HER2-positive advanced gastric and GE junction cancer Taroh.

To evaluate the availability of medication studies enrolling patients that are 80 years of age and older. Evaluation of Medication Studies Enrolling Patients.

A prospective randomized trial

Case Western Reserve University School of Medicine University Hospitals Case Medical Center Cleveland, Ohio Intrathecal Hydromorphone and Bupivacaine Combination.

Intrathecal Pumps Thomas Yeargin Biomedical Engineering BME 281 Section 1.

Opioids plus adjuvants for cancer pain: systematic review Mike Bennett Professor of Palliative Medicine Lancaster University, UK.

Cortés J et al. ASCO 2009; Abstract (Poster Discussion)

Campbell’s & Literature review. Campbell 9 th & 10 th edition Cytoreductive nephrectomy  Palliation for: 1. Severe bleeding. 2. Pain. 3. Paraneoplastic.

1 Presented by Kenneth M. Verburg, Ph.D. at the Arthritis Advisory Committee meeting 07/29/02.

Slavica Lahajnar Institute of Oncology Ljubljana Choice of Analgesic Appropriate to Pain Intensity PMI in Patients at the Institute of Oncology.

Raafat R. Abdel-Malek, MD, FRCR Ass. Prof Clinical Oncology Cairo University, Egypt Efficacy & Toxicity of Sunitinib in mRCC patients in Egypt.

HEIT TEMPLATE.PPT 1 The Ten Steps of Universal Precautions in Pain Medicine 1. 1.Diagnosis with appropriate differential 2. 2.Psychological assessment.

VBWG OASIS-6 The Sixth Organization to Assess Strategies in Acute Ischemic Syndromes trial.

PATIENT CASE Module 3 Date of preparation: June 2015 HQ/EFF/15/0024h.

CON - 1 Conclusions C David R. Parkinson Vice President, Global Head, Clinical Research and Development Novartis Pharmaceuticals Corporation.

Erlotinib plus Gemcitabine Compared with Gemcitabine Alone in Patients with Advanced Pancreatic Cancer: A Phase III Trial of the National Cancer Institute.

Intrathecal Morphine Usage in Hepatobiliary Surgery Dr David Cosgrave Dr Era Soukhin Dr Anand Puttapa Dr Niamh Conlon.

MA.17R: Reduced Risk of Recurrence With Extending Adjuvant Letrozole Beyond 5 Yrs in Postmenopausal Women With Early-Stage Breast Cancer CCO Independent.

Scenario 1 Patient is entering terminal phase MST 120mg bd sevredol 40mg if required metoclopramide 10mg tds diclofenac 50mg tds contact: unable to take.

Interventional Pain Management

“Thriasio” General Hospital

Table 1: Patient Demographics

Bladder Cancer and Prostatic Cancer

H Aladin1, A Tameem2, M Rushton3, E Roe3, A Jennings4

Figure 3 Numerical pain rating scores (NRS) before initiation of intrathecal therapy and at a 4–6-week follow-up visit. The thicker lines denote superimposed.

Presented By Luca Malorni at 2017 ASCO Annual Meeting

Pain Management Doctor San Antonio | Spine Care in San Antonio Texas

CDK 4 and 6 Inhibitors in HR-Positive Breast Cancer: Implementing Paradigms in Clinical Practice.

Bone-Targeted Therapy in the Adjuvant Breast Cancer Setting

CDK 4 and 6 Inhibitors in HR-Positive Breast Cancer: A Clinical Update

This program will include a discussion of off-label treatment and devices and investigational agents and devices not approved by the FDA for use in the.

A Randomized, Double-Blind, Placebo-Controlled Study of Intrathecal Ziconotide in Adults with Severe Chronic Pain Richard L. Rauck, MD, Mark S. Wallace,

Bone-Targeted Therapy in the Adjuvant Breast Cancer Setting

An Effective Treatment of Severe Complex Regional Pain Syndrome Type 1 in a Child Using High Doses of Intrathecal Ziconotide Michael Stanton-Hicks, MD,

Lessons Learned In Opioid Treatment From the Pain Action Consulting Team.

Krop I et al. SABCS 2009;Abstract 5090.

Treatment of HR+ Breast Cancer: A Clinical Update

Pain, Fatigue, and Sleep Disturbances in Oncology Outpatients Receiving Radiation Therapy for Bone Metastasis Christine Miaskowski, RN, PhD, FAAN, Kathryn.

Investigator - Dr Pramod S. Chinder

OPIOID TOXICITY AND SPINAL ANALGESIA

The Road to Quality Improvement in HER2-Positive Breast Cancer

When Is Intrathecal Drug Delivery Appropriate?

Management of Advanced Pancreatic Adenocarcinoma

Neoadjuvant Adjuvant Curative Palliative

Background Cancers are among the leading causes of morbidity and mortality worldwide, responsible for 18.1 million new cases and 9.6 million deaths in.

Methadone Analgesia in Cancer Pain Patients on Chronic Methadone Maintenance Therapy Paolo L Manfredi, MD, Gilbert R Gonzales, Andrea L Cheville, Craig.

No evidence for sex differences in the severity and treatment of cancer pain Janet M. Edrington, RN, MS, Steven Paul, PhD, Marylin Dodd, RN, PhD, Claudia.

When Is Intrathecal Drug Delivery Appropriate?

A single centre experience of febrile neutropenia rates in long acting compared with short acting GCSF preparations in breast cancer patients Dr Rebecca.

Presentation transcript:

Disclosures ME – None OU – None BB – Consultant for Jazz Pharmaceuticals – Consultant for Medtronic

Ziconotide Synthetic selective N-type Calcium Channel blocker Problem: Poor pain control in cancer patients despite high dose opioid and adjuvant medications Objective: Demonstrate that single shot intrathecal trials of ziconotide effectively reduce cancer related pain

Study Design Retrospective chart review Three year time period ( ) Single shot bolus trials of ziconotide – Both mono- and combination trials Pre-trial and 24 hr post-procedure numeric pain scores Successful trial: > 30% numeric pain score reduction Etiology of pain was tumor or cancer related treatments

Demographic Data 40 individual patients – 44 independent trials Tumor Related Treatment Related Other

40 Patients 30 Successful Trials (75%) 1 Successful Retrial 10 Failed Trials (25%) 3 Failed Retrials

Ziconotide Doses Mean (mcg) N403010

Combination Effects Zicono (mcg) N Bupiv (mg) Successful Trials Ziconotide alone +Bupivacaine Ziconotide alone +Bupivacaine Failed Trials

Dose Distribution

Diagnoses of Successful Trials Metastatic Disease Metastasis to Spine Post-laminectomy Pain Locally Advanced Disease CIPN Compression Fractures Other

Conclusions Single shot intrathecal ziconotide produces robust analgesia in cancer pain patients The average dose of ziconotide for successful trials was approximately 2.5 mcg Bupivacaine did not appear to produce an additive or synergistic effect for ziconotide Ziconotide successfully produced analgesia in patients with metastatic cancer pain, chronic post-surgical pain, and CIPN.