Evidence map›Paper›PMID 40029420›Full record

GuidelineSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

Opioid conversion in adults with cancer: MASCC-ASCO-AAHPM-HPNA-NICSO guideline.

Mellar P Davis, Andrew Davies, Mary Lynn McPherson, Akhila S Reddy, Judith A Paice, Eric J Roeland, Declan Walsh, Sebastiano Mercadante, Amy A Case, Robert M Arnold and 5 more

Abstract readConsensus StatementPractice Guideline
PubMed Publisher
In one paragraph

Guideline in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Reassessing opioid conversion guidelines: narrow consensus and clinical challenges.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Mellar P DavisLevine Cancer Center, Charlotte, NC, USA. Mellar.Davis@atriumhealth.org.
Andrew DaviesTrinity College Dublin, Dublin, Ireland.
Mary Lynn McPhersonUniversity of Maryland, Baltimore, MD, USA.
Akhila S ReddyUniversity of Texas MD Anderson Cancer Center, Houston, TX, USA.
Judith A PaiceNorthwestern University Feinberg School of Medicine, Chicago, IL, USA.
Eric J RoelandOregon Health and Science University, Knight Cancer Institute, Portland, OR, USA.
Declan WalshAtrium Health, Levine Cancer Center, Charlotte, NC, USA.
Sebastiano MercadanteLa Maddalena Cancer Center, Palermo, Italy.
Amy A CaseRoswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Robert M ArnoldIcahn School of Medicine at Mt Sinai, New York, NY, USA.
Eriko SatomiDepartment of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.
Gregory CrawfordNorthern Adelaide Local Health Network, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Eduardo BrueraUniversity of Texas MD Anderson Cancer Center, Houston, TX, USA.
Kari BohlkeAmerican Society of Clinical Oncology, Alexandria, VA, USA.
Carla RipamontiNetwork Italiano Cure Di Supporto in Oncologia (NICSO), Universita' Degli Studi Di Brescia, Brescia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo standardize and improve the safety and efficacy of opioid conversion in people with cancer.

methodsThe Multinational Association of Supportive Care in Cancer (MASCC), American Society of Clinical Oncology (ASCO), American Academy of Hospice and Palliative Medicine (AAHPM), Hospice and Palliative Nurses Association (HPNA), and Network Italiano Cure di Supporto in Oncologia (NICSO) convened an Expert Panel to develop recommendations based on a systematic review of the literature and a formal consensus process. The systematic review focused on randomized and non-randomized studies published from database inception to June 2022. A modified Delphi approach was used to develop and finalize recommendations. Recommendations developed by the Expert Panel underwent two rounds of consensus voting before being finalized.

resultsThe systematic review, published separately, identified 208 eligible studies. These studies provided mixed and inclusive findings regarding optimal approaches to opioid conversion. In consensus voting, 58 of 84 statements met or exceeded the required 75% level of agreement and were accepted. This process demonstrated some consistencies in conversion ratios between particular opioids internationally, but also uncovered variability in opioid conversion ratios among experts, particularly for methadone. RECOMMENDATIONS: The recommendations address three main topics: pre-conversion assessments, strategies for conversion, and post-conversion assessments. The goal is to reduce the relative risk of overdosing or under-dosing opioids when converting from one opioid to another or converting administration routes. The strength of the evidence from the trials is modest, and there are large clinical practice and research gaps. The panel hopes this guideline will establish an international best practice baseline that can be built upon by new research and better-designed trials. Additional information is available at www.asco.org/supportive-care-guidelines .

Indexed as

Analgesics, OpioidCancer PainNeoplasmsAdultConsensusDelphi TechniqueHumansPalliative CareAnalgesics, OpioidConversionDelphi consensusGuidelineOpioid

Identifiers

PMID40029420

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.