Reconstructing analgesic trials

PURPOSE OF REVIEW: Changes in drug trial designs in oncology, which involve targeted therapies and well genotyped cancers have important implications to the present trial designs used for analgesic development. RECENT FINDINGS: Pain phenotypes influence analgesic responses. Analgesics can now be targeted to pain phenotypes. IMMPACT strategies should be modified using pharmacokinetic-pharmacodynamics and phase II-III trial designs commonly used in oncology. SUMMARY: Modifying analgesic trial designs will facilitate the development of targeted analgesics and improve the 'signal-to-noise' ratio over present analgesic trial strategies, which are largely based on pain severity and changes in pain intensity over time.