open access
Pruritus in Cancer. Current Understanding and Treatment
Affiliations- Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
open access
Abstract
Pruritus in cancer is rare and heterogenous. In the past two decades our understanding of pruritus has
dramatically increased and new therapies have emerged. New strategies and drugs are being introduced
or are expected soon. An important concept concerning mechanism of pruritus in cancer is neuroinflammation,
also in the periphery as well as in the spinal cord and brain, where Toll-like receptors on the
surfaces of microglia and many other macrophages play a key role. These receptors are influenced by
many existing drugs like opioids and opioid antagonists, serotonin reuptake inhibitors, and probably few
others. Another strategy is disruption of signal transmission in the skin, spinal cord, and brain by the NK1
antagonists aprepitant, serlopitant, gabapentin, and pregabalin. None of the types of pruritus responds
to antihistamines, and these drugs should be avoided.
Palliat Med Pract 2020; 14, 1: 16–21
Abstract
Pruritus in cancer is rare and heterogenous. In the past two decades our understanding of pruritus has
dramatically increased and new therapies have emerged. New strategies and drugs are being introduced
or are expected soon. An important concept concerning mechanism of pruritus in cancer is neuroinflammation,
also in the periphery as well as in the spinal cord and brain, where Toll-like receptors on the
surfaces of microglia and many other macrophages play a key role. These receptors are influenced by
many existing drugs like opioids and opioid antagonists, serotonin reuptake inhibitors, and probably few
others. Another strategy is disruption of signal transmission in the skin, spinal cord, and brain by the NK1
antagonists aprepitant, serlopitant, gabapentin, and pregabalin. None of the types of pruritus responds
to antihistamines, and these drugs should be avoided.
Palliat Med Pract 2020; 14, 1: 16–21
Keywords
pruritus, itch, cancer, paraneoplastic phenomenon, serotonin reuptake inhibitors, paroxetine, sertraline, gabapentin, pregabalin, aprepitant
About this articleTitle
Pruritus in Cancer. Current Understanding and Treatment
Journal
Palliative Medicine in Practice
Issue
Article type
Review paper
Pages
16-21
Published online
2020-05-08
Page views
1149
Article views/downloads
690
DOI
Bibliographic record
Palliat Med Pract 2020;14(1):16-21.
Keywords
pruritus
itch
cancer
paraneoplastic phenomenon
serotonin reuptake inhibitors
paroxetine
sertraline
gabapentin
pregabalin
aprepitant
Authors
Zbigniew Zylicz
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