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Can Naloxegol Therapy Improve Quality of Life in Patients with Advanced Cancer?

National Tumor Assistance (ANT), Via Jacopo di Paolo, 36-40128 Bologna, Italy
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Academic Editor: Marco Cesare Maltoni
Cancers 2021, 13(22), 5736; https://doi.org/10.3390/cancers13225736
Received: 27 September 2021 / Revised: 5 November 2021 / Accepted: 12 November 2021 / Published: 16 November 2021
(This article belongs to the Section Cancer Nursing and Care)
The frequent use of opioid in-home palliative care settings is associated with a high incidence of opioid-induced constipation (OIC) that can significantly worsen a cancer patient’s quality of life. Laxative therapy is the first-line in OIC treatment, and although its application is recommended from the beginning of opioid therapy, in most cases it does not resolve the symptoms. Naloxegol is the specific target therapy for opioid-induced constipation. To our knowledge this is the first study aimed at evaluating the impact of a naloxegol therapy on the quality of life of advanced cancer patients with a short or very short life expectancy in a home palliative setting.
This observational study aims to evaluate the efficacy of naloxegol therapy in resolving opioid-induced constipation (OIC) and in improving the quality of life in a home palliative care cancer setting. Advanced cancer patients with OIC (Rome IV criteria) not relieved by laxatives started a naloxegol therapy 25 mg/day for 4 weeks. Quality of life was evaluated by Patient Assessment of Constipation Quality-of-Life (PAC-QoL) at day 0 and day 28; background pain by Numerical Rating Scale, number of weekly spontaneous bowel movements and Bowel Function Index (BFI) were evaluated at day 0 and every week. Seventy-eight patients who completed the 4-week study improved all four PAC-QoL dimensions (physical and psychological discomfort, worries/concerns and satisfaction level). Weekly spontaneous bowel movements increased and BFI improved. Background pain reduced after seven days and remained lower during the following weeks. Seventy-two patients dropped out the study before day 28 with a reduced survival compared to patients completing the study. Even in these patients, an improvement of bowel function was observed after two weeks. Naloxegol was effective in improving the quality of life, resolving OIC and reducing overall pain in patients with advanced cancer. View Full-Text
Keywords: cancer; naloxegol; opioid-induced constipation; palliative care; antagonists; opioid receptor; quality of life cancer; naloxegol; opioid-induced constipation; palliative care; antagonists; opioid receptor; quality of life
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MDPI and ACS Style

Ostan, R.; Gambino, G.; Malavasi, I.; Ronga, G.; Solipaca, M.; Spunghi, M.; Varani, S.; Pannuti, R.; Ruggeri, E. Can Naloxegol Therapy Improve Quality of Life in Patients with Advanced Cancer? Cancers 2021, 13, 5736. https://doi.org/10.3390/cancers13225736

AMA Style

Ostan R, Gambino G, Malavasi I, Ronga G, Solipaca M, Spunghi M, Varani S, Pannuti R, Ruggeri E. Can Naloxegol Therapy Improve Quality of Life in Patients with Advanced Cancer? Cancers. 2021; 13(22):5736. https://doi.org/10.3390/cancers13225736

Chicago/Turabian Style

Ostan, Rita, Giuseppe Gambino, Italo Malavasi, Gianluca Ronga, Maria Solipaca, Michela Spunghi, Silvia Varani, Raffaella Pannuti, and Enrico Ruggeri. 2021. "Can Naloxegol Therapy Improve Quality of Life in Patients with Advanced Cancer?" Cancers 13, no. 22: 5736. https://doi.org/10.3390/cancers13225736

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