Treatment for Chronic Pain in Patients With Advanced Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically or cytologically proven advanced cancer with chronic pain
• •Cancer pain requiring strong opioids having an average pain score of less than 6/10 on the visual analog scale within last 24 hours
• •Pain managed by a stable maintenance dose of MS-Contin formulation of morphine for at least 2 days with no more than 2 breakthrough immediate release morphine doses per 24 hours
• •Pain that is expected to be controlled by a stable and adequate total daily dose of sustained release morphine for the first 7 days of the study
• •PATIENT CHARACTERISTICS:
• •Age:
• •16 and over
• •Performance status:
• •Not specified
• •Life expectancy:
• •At least 2 months
• •Hematopoietic:
• •Not specified
• •Hepatic:
• •SGOT or SGPT no greater than 3 times upper limit of normal (ULN)
• •No liver disease
• •Renal:
• •Creatinine no greater than 2 times ULN
• •No kidney failure
• •Pulmonary:
• •No clinically significant respiratory depression
• •No severe obstructive airway disease
• •Other:
• •Fluent in English or French
• •No known hypersensitivity or allergy to study medications or components or other multiple drug allergies
• •Normal cognition defined by the Folstein Mini-Mental State Questionnaire (at least 24/30 correct)
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •Not specified
• •Chemotherapy:
• •At least 14 days since prior chemotherapy
• •Endocrine therapy:
• •Concurrent steroids allowed
• •Radiotherapy:
• •At least 14 days since prior analgesic radiotherapy
• •Surgery:
• •Not specified
• •Other:
• •At least 3 months since prior investigational agents
• •At least 1 month since prior clinical study
• •No concurrent analgesics other than morphine
• •No other concurrent medications containing dextromethorphan
• •Concurrent antidepressant medication allowed
• •Concurrent nonsteroidal antiinflammatory drugs allowed
• •At least 14 days since prior monoamine oxidase (MAO) inhibitors
• •No concurrent MAO inhibitors