Background & Aims

Cancer will soon be the most prevalent disease worldwide. Most patients are diagnosed with advanced disease, which is associated with distressing symptoms, pain being the most debilitating with great impact on the quality of life. Cannabinoids are a class of drugs intensively studied for their analgesic properties; however, they still lack clear indications for cancer patients. Our aim is to investigate the safety and efficacy of cannabinoids for analgesia in advanced cancer patients.

Methods

The study protocol was registered on PROSPERO (CRD42023479375), and a systematic search was conducted using three main databases (PubMed, Embase, and CENTRAL). Interventional and observational articles, where cancer patients were administered any type of cannabinoid for pain were eligible for analysis. The mean difference between the baseline and after-intervention values of symptom intensity were assessed, for which weighted means and pooled proportions were calculated with a 95% confidence interval (CI) and a random-effects model.

Results

After title-abstract and full-text selection, 96 articles were found to be eligible. The pain was assessed using different symptom rating scales (0-best, the highest number-worst). The preliminary results show that analgesia greatly depends on the THC and CBD content. Patients receiving THC-based drugs had a decrease in pain of -1.27 (-2.12; -0.43 95%CI), CBD-based drugs decreased pain with -0.92 (-1.97; 0.13 95%CI), whereas drugs which combined different ratios of THC and CBD failed to conduct to clinically relevant analgesia, the mean difference from baseline being -0.38 (-0.7; -0.06 95%CI).

Conclusions

Cannabinoids could be beneficial for cancer patients experiencing pain. However, the effects may vary significantly depending on the type of cannabinoid, dosage, and form of administration. These preliminary results need to be followed by further analysis, so proper indication/contraindication of the drugs can be suggested.

References

1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4. PMID: 33538338.
2.Mestdagh F, Steyaert A, Lavand’homme P. Cancer Pain Management: A Narrative Review of Current Concepts, Strategies, and Techniques. Curr Oncol. 2023 Jul 18;30(7):6838-6858. doi: 10.3390/curroncol30070500. PMID: 37504360; PMCID: PMC10378332.
3. Meng H, Dai T, Hanlon JG, Downar J, Alibhai SMH, Clarke H. Cannabis and cannabinoids in cancer pain management. Curr Opin Support Palliat Care. 2020 Jun;14(2):87-93. doi: 10.1097/SPC.0000000000000493. PMID: 32332209.

Presenting Author

Ioana Creanga-Murariu

Poster Authors

Ioana Creanga-Murariu

Dr

Advanced Research and Development Center for Experimental Medicine (CEMEX)

Lead Author

Ioana-Irina Rezus

Centre for Translational Medicine, Semmelweis University, Budapest, Hungary

Lead Author

Roshanak Karami

Semmelweis University, Budapest, Hungary

Lead Author

Anett Rancz

Centre for Translational Medicine, Semmelweis University, Budapest, Hungary

Lead Author

Dániel Sándor Veres

Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary

Lead Author

Maria Anne Engh

Centre for Translational Medicine, Semmelweis University, Budapest, Hungary

Lead Author

Mahmoud Obeidat

Centre for Translational Medicine, Semmelweis University, Budapest, Hungary

Lead Author

Stefania Bunduc

Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

Lead Author

Bogdan-Ionel Tamba

Advanced Research and Development Center for Experimental Medicine (CEMEX); Iasi

Lead Author

Péter Hegyi

Centre for Translational Medicine, Semmelweis University, Budapest, Hungary

Lead Author

Topics

  • Treatment/Management: Cannabinoids and Cannabis