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Erschienen in: Supportive Care in Cancer 12/2021

04.06.2021 | Original Article

A randomized trial of medical cannabis in patients with stage IV cancers to assess feasibility, dose requirements, impact on pain and opioid use, safety, and overall patient satisfaction

verfasst von: Dylan M. Zylla, Justin Eklund, Grace Gilmore, Alissa Gavenda, Jordan Guggisberg, Gabriela VazquezBenitez, Pamala A. Pawloski, Tom Arneson, Sara Richter, Angela K. Birnbaum, Stephen Dahmer, Matthew Tracy, Arkadiusz Dudek

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2021

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Abstract

Purpose

The prevalence of medical cannabis (MC) use in patients with cancer is growing, but questions about safety, efficacy, and dosing remain. Conducting randomized, controlled trials (RCTs) using state-sponsored MC programs is novel and could provide data needed to guide patients and providers.

Methods

A pilot RCT of patients with stage IV cancer requiring opioids was conducted. Thirty patients were randomized 1:1 to early cannabis (EC, n = 15) versus delayed start cannabis (DC, n = 15). The EC group obtained 3 months (3 M) of MC through a state program at no charge, while the DC group received standard oncology care without MC for the first 3 M. Patients met with licensed pharmacists at one of two MC dispensaries to determine a suggested MC dosing, formulation, and route. Patients completed surveys on pain levels, opioid/MC use, side effects, and overall satisfaction with the study.

Results

Interest in the study was high as 36% of patients who met eligibility criteria ultimately enrolled. The estimated mean daily THC and CBD allotments at 3 M were 34 mg and 17 mg, respectively. A higher proportion of EC patients achieved a reduction in opioid use and improved pain control. No serious safety issues were reported, and patients reported high satisfaction.

Conclusion

Conducting RCTs using a state cannabis program is feasible. The addition of MC to standard oncology care was well-tolerated and may lead to improved pain control and lower opioid requirements. Conducting larger RCTs with MC in state-sponsored programs may guide oncology providers on how to safely and effectively incorporate MC for interested patients.
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Metadaten
Titel
A randomized trial of medical cannabis in patients with stage IV cancers to assess feasibility, dose requirements, impact on pain and opioid use, safety, and overall patient satisfaction
verfasst von
Dylan M. Zylla
Justin Eklund
Grace Gilmore
Alissa Gavenda
Jordan Guggisberg
Gabriela VazquezBenitez
Pamala A. Pawloski
Tom Arneson
Sara Richter
Angela K. Birnbaum
Stephen Dahmer
Matthew Tracy
Arkadiusz Dudek
Publikationsdatum
04.06.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 12/2021
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-021-06301-x

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