bims-rebome 2026-03-15 papers

Exp Ther Med. 2026 Apr;31(4): 108

Efficacy of opioids in combination with gabapentin vs. opioids alone in the treatment of patients with cancer-related pain due to bone metastases from malignant neoplasms: A meta-analysis.

Hongli Zhou, Jun Feng, Zuolei Tang.

Cancer pain seriously affects the quality of life of patients with malignant tumors, especially the pain caused by bone metastases. In recent years, gabapentin has demonstrated potential value in the treatment of cancer pain from bone metastases, providing promising new ideas for clinical treatment. The aim of the present study was to systematically evaluate the efficacy of opioids combined with gabapentin compared with opioids alone in the treatment of cancer-related pain due to bone metastases of malignant tumors based on meta-analysis. PubMed, Embase, Web of Science, China National Knowledge Infrastructure, VIP, Wanfang Data and other databases were searched to collect randomized controlled trials and non-randomized controlled trials of opioids combined with gabapentin compared with opioids alone for the treatment of cancer pain due to malignant bone metastases. The quality of the included studies was evaluated using the Cochrane Risk of Bias Assessment 2.0 tool and the Newcastle-Ottawa Scale. Subsequent meta-analyses were performed using the R language. A total of 25 studies including 1,805 patients were included. Meta-analysis results showed that gabapentin in combination with opioids exhibited a notable advantage in reducing pain scores compared with opioids alone (mean difference=1.26; 95% CI, 0.88-1.65). Subgroup analyses by study type, sample size and treatment regimen revealed that heterogeneity was influenced by a number of factors. Sensitivity analyses demonstrated the robustness of the findings. However, limited data on adverse effects precluded comprehensive safety analysis. Gabapentin in combination with opioids may be an effective regimen for the treatment of cancer-related pain associated with bone metastases from malignant tumors. However, due to the heterogeneity of the included studies and limited safety data, clinical application requires caution and individualized treatment regimens based on patient-specific conditions.

Keywords: bone metastases; cancer pain; gabapentin; meta-analysis; opioids

DOI: https://doi.org/10.3892/etm.2026.13103

J Natl Compr Canc Netw. 2026 Mar 09. 1-5

Predictors of Skeletal-Related Events and Quality-of-Life Dimensions Among Patients With High-Risk Asymptomatic Bone Metastases With or Without Early Radiation Therapy: Secondary Analysis of a Multicenter Randomized Phase II Clinical Trial.

Kaitlyn Lapen, Zhigang Zhang, Charlie White, Christopher A Barker, Rupesh Kotecha, Alyson F McIntosh, Ryan D Nipp, Puneeth Iyengar, Jonathan T Yang, Divya Yerramilli, Erin F Gillespie.

BACKGROUND: Early radiation therapy (RT) reduces the rate of skeletal-related events (SRE), which can affect patients' functionality and quality of life (QoL). We aimed to determine predictors of SRE and the effect of early RT on individual QoL dimensions.
METHODS: We conducted a secondary analysis of a multicenter, randomized phase II trial (ClinicalTrials.gov identifier: NCT03523351) assessing early RT to asymptomatic, high-risk bone metastases. A competing risks analysis evaluated patient-level factors associated with SRE. Linear mixed models evaluated dimensions of the EuroQol 5-Dimension 5-Level (EQ-5D-5L) QoL assessment (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) over time by study arm.
RESULTS: Overall, 78 patients with 122 bone metastases were enrolled; 71 (91%) patients were evaluable for the primary endpoint of SRE (35 patients in the early RT arm vs 36 in the control arm). A total of 15 SREs occurred among 11 unique patients during the 1-year follow-up period. Receipt of early RT was statistically significantly correlated with a lower risk of SRE (hazard ratio, 0.09; 95% CI, 0.01-0.66; P=.018). In the linear mixed model predicting self-care, the interaction between time and study arm was statistically significant (P=.022). At 6 months, the control arm had a decline in self-care, whereas patients in the RT arm experienced an improvement. Anxiety/depression was worse at 3 months in the RT arm, but this was not statistically significant (P=.120).
CONCLUSIONS: Rates of SRE were high among patients with bone metastases, and these findings underscore the importance of early RT in their prevention. Patient-reported QoL suggests preservation of self-care with early RT, and that survival beyond 6 months may be needed to observe a benefit. Further research regarding patient selection and the impact of SRE on QoL and functionality are needed, and a phase III randomized trial (NRG CC014; NCT06745024) is in progress.
CLINICALTRIALS: gov identifier: NCT03523351.

DOI: https://doi.org/10.6004/jnccn.2025.7126

Front Immunol. 2026 ;17 1773998

Radiotherapy plus immune checkpoint inhibitors versus immune checkpoint inhibitors alone for non-small cell lung cancer with bone metastases: a systematic review and meta-analysis of comparative cohort studies.

Yingding Ruan, Wenjun Cao, Chuan Long, Siyu Guo, Jianwei Han, Zhendong Chen, Ting Zhang.

Background: Bone metastases are a frequent and clinically consequential complication of advanced non-small cell lung cancer (NSCLC), associated with substantial morbidity and poor survival. Whether adding radiotherapy (RT) to immune checkpoint inhibitors (ICIs) improves outcomes remains uncertain.
Methods: We searched PubMed, Cochrane Library, Web of Science, Scopus, and Embase (January 2010-October 2025) for comparative studies of RT + ICI versus ICI alone in patients with NSCLC and radiologically or pathologically confirmed bone metastases. Primary outcomes were overall survival (OS) and progression-free survival (PFS); secondary outcomes were objective response rate (ORR), grade ≥3 adverse events (AEs), and skeletal-related events (SREs). Study quality was assessed using the Newcastle-Ottawa Scale. Hazard ratios (HRs) were pooled for time-to-event outcomes and odds ratios (ORs) for binary outcomes, using fixed- or random-effects models according to heterogeneity.
Results: Six studies (n = 1,631) were included. RT + ICI improved OS (HR 0.58, 95% CI 0.44-0.76; I² = 68%) and PFS (HR 0.44, 95% CI 0.37-0.53; I² = 0%) versus ICI alone. The OS benefit persisted after excluding the large database cohort (HR 0.52, 95% CI 0.42-0.63). ORR was not significantly different (OR 1.68, 95% CI 0.77-3.66; I² = 74%), and grade ≥3 AEs were comparable (OR 1.00, 95% CI 0.78-1.27; I² = 0%). RT + ICI reduced SREs (OR 0.16, 95% CI 0.04-0.68; I² = 0%), but this estimate is based on sparse events.
Conclusions: Low- to moderate-quality observational evidence suggests that RT combined with ICIs may be associated with improved survival without an apparent increase in severe toxicity in NSCLC with bone metastases. Any apparent reduction in SREs should be interpreted cautiously given the sparse event data. Prospective phase III randomized trials are needed to confirm causality and refine patient selection.
Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251230736.

Keywords: bone metastases; immune checkpoint inhibitors; meta-analysis; non-small cell lung cancer; radiotherapy

DOI: https://doi.org/10.3389/fimmu.2026.1773998

J Neurooncol. 2026 Mar 13. pii: 52. [Epub ahead of print]177(1):

Application of enhanced recovery after surgery for patients with spinal metastasis: a systematic review and meta-analysis.

Shahab Aldin Sattari, S Farzad Maroufi, John N Theodore, Kelly Jiang, Albert Antar, Wuyang Yang, Tej D Azad, A Daniel Davidar, Carly Weber-Levine, Louis Chang, Alexander C Whiting, Daniel Lubelski, Ali Bydon, Timothy Witham, Jon Weingart, Chetan Bettegowda, Allan Belzberg, Nicholas Theodore.

Keywords: Cancer; Enhanced recovery; Metastasis; Morbidity; Oncology; Spine; Surgery

DOI: https://doi.org/10.1007/s11060-025-05401-6