Opioid requirement, opioid receptor expression, and clinical outcomes in patients with advanced prostate cancer
© 2013 American Cancer Society..
BACKGROUND: Preclinical studies show that opioids stimulate angiogenesis and tumor progression through the mu opioid receptor (MOR). Although MOR is overexpressed in several human malignancies, the effect of chronic opioid requirement on cancer progression or survival has not been examined in humans.
METHODS: We performed a retrospective analysis on 113 patients identified in the Minneapolis VA Tumor Registry (test cohort) and 480 patients from the national VA Central Cancer Registry (validation cohort) who had been diagnosed with stage IV prostate cancer between 1995 and 2010 to examine whether MOR expression or opioid requirement is associated with disease progression and survival. All opioids were converted to oral morphine equivalents for comparison. Laser scanning confocal microscopy was used to analyze MOR immunoreactivity in prostate cancer biopsies. The effects of variables on outcomes were analyzed in univariable and multivariable models.
RESULTS: In patients with metastatic prostate cancer, MOR expression and opioid requirement were independently associated with inferior progression-free survival (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.33-2.07, P<.001 and HR 1.08, 95% CI 1.03-1.13, P<.001, respectively) and overall survival (HR 1.55, 95% CI 1.20-1.99, P<.001 and HR 1.05, 95% CI 1.00-1.10, P = .031, respectively). The validation cohort confirmed that increasing opioid requirement was associated with worse overall survival (HR 1.005, 95% CI 1.002-1.008, P = .001).
CONCLUSION: Higher MOR expression and greater opioid requirement are associated with shorter progression-free survival and overall survival in patients with metastatic prostate cancer. Nevertheless, clinical practice should not be changed until prospective randomized trials show that opioid use is associated with inferior clinical outcomes, and that abrogation of the peripheral activities of opioids ameliorates this effect.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2013 |
|---|---|
| Erschienen: |
2013 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:119 |
|---|---|
| Enthalten in: |
Cancer - 119(2013), 23 vom: 01. Dez., Seite 4103-10 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Zylla, Dylan [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 16.01.2014 Date Revised 21.10.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1002/cncr.28345 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM231502702 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM231502702 | ||
| 003 | DE-627 | ||
| 005 | 20231224090901.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231224s2013 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/cncr.28345 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0771.xml |
| 035 | |a (DE-627)NLM231502702 | ||
| 035 | |a (NLM)24104703 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Zylla, Dylan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Opioid requirement, opioid receptor expression, and clinical outcomes in patients with advanced prostate cancer |
| 264 | 1 | |c 2013 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.01.2014 | ||
| 500 | |a Date Revised 21.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2013 American Cancer Society. | ||
| 520 | |a BACKGROUND: Preclinical studies show that opioids stimulate angiogenesis and tumor progression through the mu opioid receptor (MOR). Although MOR is overexpressed in several human malignancies, the effect of chronic opioid requirement on cancer progression or survival has not been examined in humans | ||
| 520 | |a METHODS: We performed a retrospective analysis on 113 patients identified in the Minneapolis VA Tumor Registry (test cohort) and 480 patients from the national VA Central Cancer Registry (validation cohort) who had been diagnosed with stage IV prostate cancer between 1995 and 2010 to examine whether MOR expression or opioid requirement is associated with disease progression and survival. All opioids were converted to oral morphine equivalents for comparison. Laser scanning confocal microscopy was used to analyze MOR immunoreactivity in prostate cancer biopsies. The effects of variables on outcomes were analyzed in univariable and multivariable models | ||
| 520 | |a RESULTS: In patients with metastatic prostate cancer, MOR expression and opioid requirement were independently associated with inferior progression-free survival (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.33-2.07, P<.001 and HR 1.08, 95% CI 1.03-1.13, P<.001, respectively) and overall survival (HR 1.55, 95% CI 1.20-1.99, P<.001 and HR 1.05, 95% CI 1.00-1.10, P = .031, respectively). The validation cohort confirmed that increasing opioid requirement was associated with worse overall survival (HR 1.005, 95% CI 1.002-1.008, P = .001) | ||
| 520 | |a CONCLUSION: Higher MOR expression and greater opioid requirement are associated with shorter progression-free survival and overall survival in patients with metastatic prostate cancer. Nevertheless, clinical practice should not be changed until prospective randomized trials show that opioid use is associated with inferior clinical outcomes, and that abrogation of the peripheral activities of opioids ameliorates this effect | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 4 | |a humans | |
| 650 | 4 | |a morphine | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a mu opioid receptors | |
| 650 | 4 | |a opioid analgesics | |
| 650 | 4 | |a opioid receptors | |
| 650 | 4 | |a opioids | |
| 650 | 4 | |a pain | |
| 650 | 4 | |a prostatic neoplasms | |
| 650 | 4 | |a retrospective studies | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 650 | 7 | |a Receptors, Opioid, mu |2 NLM | |
| 700 | 1 | |a Gourley, Brett L |e verfasserin |4 aut | |
| 700 | 1 | |a Vang, Derek |e verfasserin |4 aut | |
| 700 | 1 | |a Jackson, Scott |e verfasserin |4 aut | |
| 700 | 1 | |a Boatman, Sonja |e verfasserin |4 aut | |
| 700 | 1 | |a Lindgren, Bruce |e verfasserin |4 aut | |
| 700 | 1 | |a Kuskowski, Michael A |e verfasserin |4 aut | |
| 700 | 1 | |a Le, Chap |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Kalpna |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Pankaj |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cancer |d 1948 |g 119(2013), 23 vom: 01. Dez., Seite 4103-10 |w (DE-627)NLM000028649 |x 1097-0142 |7 nnns |
| 773 | 1 | 8 | |g volume:119 |g year:2013 |g number:23 |g day:01 |g month:12 |g pages:4103-10 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/cncr.28345 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 119 |j 2013 |e 23 |b 01 |c 12 |h 4103-10 | ||