The most advanced innovations are currently limited to dual-mechanism agents (e.g., tapentadol combining MOR agonism and norepinephrine reuptake inhibition) and novel delivery systems (e.g., iontophoretic transdermal patches or intrathecal pumps).<h4>Conclusion</h4>The cancer pain research ecosystem exhibits substantial volume growth unmatched by mechanistic innovation. The gene discussed is OPRM1; the disease is cancer.