PILOT-STUDY EVALUATING LOCAL-ANESTHETICS ADMINISTERED SYSTEMICALLY FOR TREATMENT OF PAIN IN PATIENTS WITH ADVANCED CANCER

Based on evidence that suggested that systemically administered local anesthetics might be useful in chronic pain we initiated a pilot study to evaluate the activity and toxicity of mexiletene and flecainide in the treatment of cancer pain. Twenty-one courses of either mexiletine or flecainide were administered to patients with an Eastern Cooperati ve Oncology Group performance status of three or better, who were suff ering from cancer pain inadequately controlled with opioid analgesics. Pain control was assessed by patient questionnaires to monitor benefi t and toxicity. In 17 cases, there was no suggestion of benefit. Two c ases had relatively clear-cut analgesic benefit, and two others had so me suggestion of mild-to-moderate analgesic relief. Flecainide was rel atively well tolerated, but mexiletine appeared to cause nausea and/or vomiting in five of eight patients. This pilot trial suggests that sy stemically administered local anesthetics can relieve pain in a minori ty of patients with cancer pain. (C) U.S. Cancer Pain Relief Committee , 1997.