Department of Medical Pharmacology, College of Medicine, University of Arizona, Tucson, Arizona, USA.
Curr Opin Support Palliat Care. 2020 Jun;14(2):107-111. doi: 10.1097/SPC.0000000000000496.
The treatment of cancer-induced bone pain (CIBP) has been proven ineffective and relies heavily on opioids, the target of highly visible criticism for their negative side effects. Alternative therapeutic agents are needed and the last few years have brought promising results, detailed in this review.
Cysteine/glutamate antiporter system, xc, cannabinoids, kappa opioids, and a ceramide axis have all been shown to have potential as novel therapeutic targets without the negative effects of opioids.
Review of the most recent and promising studies involving CIBP, specifically within murine models. Cancer pain has been reported by 30-50% of all cancer patients and even more in late stages, however the standard of care is not effective to treat CIBP. The complicated and chronic nature of this type of pain response renders over the counter analgesics and opioids largely ineffective as well as difficult to use due to unwanted side effects. Preclinical studies have been standardized and replicated while novel treatments have been explored utilizing various alternative receptor pathways: cysteine/glutamate antiporter system, xc, cannabinoid type 1 receptor, kappa opioids, and a ceramide axis sphingosine-1-phosphate/sphingosine-1-phosphate receptor 1.
癌症骨痛（CIBP）的治疗效果不佳，严重依赖阿片类药物，而阿片类药物的副作用备受关注。因此，需要寻找替代的治疗药物。近年来，已经取得了一些有前景的研究成果，本综述对此进行了详细介绍。
半胱氨酸/谷氨酸反向转运蛋白系统、xc、大麻素、κ 阿片受体和神经酰胺轴都被证明具有成为新型治疗靶点的潜力，且没有阿片类药物的副作用。
综述了最近涉及 CIBP 的最有前景的研究，特别是在小鼠模型中的研究。据报道，30%至 50%的癌症患者存在癌症疼痛，晚期患者的比例更高，但目前的治疗标准并不能有效治疗 CIBP。这种疼痛反应复杂且慢性，因此，非处方止痛药和阿片类药物效果不佳，而且由于副作用的原因，使用也较为困难。目前已经对临床前研究进行了标准化和复制，同时还探索了利用各种替代受体途径的新型治疗方法：半胱氨酸/谷氨酸反向转运蛋白系统、xc、大麻素 1 型受体、κ 阿片受体和神经酰胺轴鞘氨醇-1-磷酸/鞘氨醇-1-磷酸受体 1。
