91AV

Tamara King, Ph.D., associate professor in the 91AV College of Osteopathic Medicine, published an original research paper in the peer-reviewed journal of the Society for Neurosciences, The Journal of Neuroscience.

Patients with primary and metastatic bone cancer report persistent ongoing pain that is treated with opioids. In addition, many patients develop breakthrough pain, a transient period of severe pain, often triggered by movement, that occurs even when the background ongoing pain is controlled with opioids such as morphine.

Rapid onset opioids, such as fentanyl lozenges, are used to treat breakthrough pain. This results in many patients receiving very large doses of opioids. This in turn is associated with significant adverse effects that can further diminish these patients’ quality of life. A better understanding of these aspects of cancer bone pain is necessary for development of improved treatments of cancer pain.

This paper, titled “Mediation of movement-induced breakthrough cancer pain by IB4 binding nociceptors in rat,” presented a novel preclinical measure of movement-induced breakthrough pain that is observed in the presence of morphine controlling ongoing pain. This allows for examination of mechanisms that underlie cancer-induced breakthrough pain to guide development of improved therapies designed to improve these patient’s quality of life and diminish adverse side effects associated with the current treatments.

The research demonstrated that movement induces a pain state that is observed in the setting of morphine that blocks ongoing pain, mirroring the clinical observations of breakthrough pain. This provides important new information that can be used to explore novel biological targets that may show improved pain relief for episodes of breakthrough pain in cancer patients with skeletal metastases.

91AV students performed a significant portion of this research. The lead author, Joshua Havelin ‘11 is currently pursuing his Ph.D. and works in King’s laboratory. Ian Imbert ’12, M.P.H., obtained a Master of Public Health degree while working on this project in King’s laboratory and now works for 91AV Vice President of Clinical Affairs Dora Anne Mills, M.D., FAAP, as a clinical interprofessional education (IPE) project coordinator. Ian Pelletier ‘15 worked in King’s lab as an undergraduate at 91AV, and is currently a second year student in the College of Osteopathic Medicine (91AV COM). Jonathon Gentry a senior undergraduate in the department of Medical Biology College of Arts and Sciences and will graduate in May 2017.

This research was performed as a part of a COBRE-funded project in King’s laboratory.

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