New analgesics in cancer pain

Cancer pain continues to be a significant problem despite the range of analgesic and adjuvant medications available. The purpose of this review is to explore the most recent developments in the management of cancer pain.Tapentadol, launched in the United Kingdom in May 2011, represents the last new analgesic entity with a novel mode of action to enter clinical practice for moderate-to-severe pain. Recent evidence describes the benefit of duloxetine for cancer-related neuropathic pain, and parecoxib by continuous subcutaneous infusion for refractory cancer pain. There is interest in the role of cannabinoids in cancer pain management but much of the evidence to date is in chronic noncancer pain. Conflicting evidence complicates the role that biased opioid agonism may offer in terms of alternative analgesics in the future.There is development of new drugs with clinical utility on the horizon but a need for high-quality, randomized controlled trials specifically assessing efficacy and tolerability in cancer pain.