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Report: Ketamine Has No Clinical Benefit for Cancer Pain

Drug may do more harm than good (Sept. 25)

A drug that for decades has been widely used to treat cancer-related pain has no net clinical benefit, researchers at Flinders University in Victoria, South Australia, have found.

The study involved 185 patients with advanced cancer. Ninety-three patients were treated with ketamine, and the others received placebo.

The results, announced by the university on September 25 and published in the Journal of Clinical Oncology, not only showed identical benefit between the two groups but revealed significantly higher rates of toxicity and other side effects among those receiving ketamine.

Chief investigator Professor David Currow said the results of the study have highlighted the potential harm that can be caused by prescribing drugs “off label” without adequate trials.

“The role of ketamine in routine clinical care for chronic, complex cancer pain is not in any way supported by this study. The result is resoundingly negative,” Professor Currow said.

“At subanesthetic doses, ketamine has been shown to help in post-operative pain relief; so the trial of it in cancer-related pain, where the nerve itself is damaged, was a very logical step,” he added. “The question is, can you take information from one patient population and just automatically apply it to another population? The short answer is you can’t.”

Professor Currow said that “robust data” were needed to inform the care of people with advanced life-limiting illnesses.

“These people deserve exactly the same quality of care that anyone else gets in the health system. In fact, they’re more at risk than anyone else of adverse outcomes,” he said.

For more information, visit the Flinders University Web site.

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