Cannabis Impacts Tumor Response Rate to Nivolumab in Patients with Advanced Malignancies

Taha, Tarek; Meiri, David; Talhamy, S.; Wollner, Mira; Peer, Avivit; Bar‐Sela, Gil

doi:10.1634/theoncologist.2018-0383

Cited by 119 publications

(148 citation statements)

References 28 publications

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“…One third (31%) of the patients asked in our study, took medical cannabis believing that it will treat the cancer disease itself. It may be based on research showing that combinations of different compounds in cannabis can be extremely effective in destroying speci ic cancer cells [4].…”

Section: Discussionmentioning

confidence: 99%

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Expectations versus reality: Improvement of symptom control and quality of life of oncology patients using medical cannabis

Ochayon¹,

Spiro²,

Kadmon³

2020

Clin J Nurs Care Pract

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Aim: To compare the expectations and the reality of oncology patients in terms of to the use of medical cannabis, including symptom control and related quality of life. Research question: Is there a diff erence between oncology patients expectations and their reality concerning the use of medical cannabis and what do oncology patients experience regarding symptom control and quality of life? Method: This research was done in a tertiary hospital in Israel at the oncology clinic A comparative study that used self-administered questionnaires for patients who received authorization to use medical cannabis. The fi rst questionnaire was given to patients after receiving the authorization to use medical cannabis and asked about their expectations related to its use. Patients fi lled out the same questionnaire for the second time, approximately two months after. Comparison of the respondent's answers, before and after using medical cannabis, showed reality of improving symptom control and Quality of Life. Results: Seventy-four patients completed both questionnaires. Most patients reported advantage in symptom control when using medical cannabis, although their expectations were somewhat higher than the reality experienced. Advantage of using medical cannabis was also found concerning improvement of quality of life. Seventy-fi ve of patients still used medical cannabis once completing the second questionnaire and most of them reported that they would recommend the use of medical cannabis Conclusion: It can be seen from this study that for many oncology patients the use of medical cannabis may be very helpful. However, the use of cannabis is not free of side eff ects, as can be seen from the patients' reports. This has clear implications for oncology nursing practice and may lead to a better understanding of patients using medical cannabis in the future, in terms of its benefi t and side eff ects.

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Section: Discussionmentioning

confidence: 99%

“…A new Israeli study supports the idea that cannabis could be used to kill cancer cells .Biologist Dr. David Meiri of the Technion-Israel Institute of Technology, is conducting cutting-edge research showing that combinations of different compounds in cannabis can be extremely effective in destroying speci ic cancer cells [4].…”

Section: Introductionmentioning

confidence: 99%

Expectations versus reality: Improvement of symptom control and quality of life of oncology patients using medical cannabis

Ochayon¹,

Spiro²,

Kadmon³

2020

Clin J Nurs Care Pract

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“…Hindering therapeutic efficiency of human IgG4 monoclonal antibody Nivolumab is an unwanted action. Troubling results have been obtained in an oncologic study featuring the effectiveness of associating cannabis to the human IgG4 monoclonal antibody Nivolumab in the treatment of various cancers including melanoma, as cannabis decreased the response rate to the treatment, hinting at possible interactions between the therapeutic substances [205].…”

Section: Adverse Effects Of Cannabinoidsmentioning

confidence: 99%

Cannabinoids in the Pathophysiology of Skin Inflammation

et al. 2020

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Cannabinoids are increasingly-used substances in the treatment of chronic pain, some neuropsychiatric disorders and more recently, skin disorders with an inflammatory component. However, various studies cite conflicting results concerning the cellular mechanisms involved, while others suggest that cannabinoids may even exert pro-inflammatory behaviors. This paper aims to detail and clarify the complex workings of cannabinoids in the molecular setting of the main dermatological inflammatory diseases, and their interactions with other substances with emerging applications in the treatment of these conditions. Also, the potential role of cannabinoids as antitumoral drugs is explored in relation to the inflammatory component of skin cancer. In vivo and in vitro studies that employed either phyto-, endo-, or synthetic cannabinoids were considered in this paper. Cannabinoids are regarded with growing interest as eligible drugs in the treatment of skin inflammatory conditions, with potential anticancer effects, and the readiness in monitoring of effects and the facility of topical application may contribute to the growing support of the use of these substances. Despite the promising early results, further controlled human studies are required to establish the definitive role of these products in the pathophysiology of skin inflammation and their usefulness in the clinical setting.

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“…There also are significant concerns regarding drug‐drug interactions with the use of medical cannabis . For example, in patients with cancer, one study found that cannabis was the only factor significantly associated with a decreased response rate to nivolumab immunotherapy, with a decrease in the response rate from 38% to 16% when patients were taking cannabis during immunotherapy . Another review recommended caution when combining cannabis with specific agents given the potential effects of cannabis on membrane transporters and cytochrome P450 metabolism .…”

Section: Cannabis: Indications Use Versus Evidence Basementioning

confidence: 99%

Medical cannabis use among individuals with cancer: An unresolved and timely issue

Nugent

Meghani

Rogal

et al. 2020

Cancer

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The role of cannabis in cancer care is a complex and challenging issue. Cancer and its treatments currently are designated as qualifying conditions in the majority of the 33 states that now have legalized medical cannabis. 1 Consequently, cannabis use in patients with cancer is common: nearly one-quarter of individuals with cancer report current cannabis use 2,3 and >90% of cancer survivors view cannabis as potentially beneficial for symptom management and support its legalization. 4 Recent studies have suggested that physicians may be more likely to recommend cannabis to patients with cancer compared with patients with other serious illnesses, 5 and that oncologists are becoming increasingly accepting of patients using cannabis, despite their continued concerns regarding its safety and efficacy. 6,7 For example, approximately 46% of oncologists reported recommending medical cannabis clinically and approximately 80% discussed it with their patients, despite the fact that approximately 70% acknowledged that they were insufficiently educated regarding medical cannabis. 8 Thus, there appears to be a disconnect between medical cannabis's legal status and high acceptance by patients, recommendations from clinicians, and a poor evidence base concerning its safety and efficacy.A more complete and nuanced understanding of the relevant issues is imperative in this current climate of growing cannabis availability and acceptance. In this commentary, we have discussed key clinical issues related to the efficacy and safety of cannabis in patients with cancer and noted important lingering questions for clinical practice and research in this area. Cannabis: Indications, Use Versus Evidence BaseApproximately 75% of individuals with cancer use cannabis for symptom management, most commonly pain, nausea, and sleep disruption 9,10 ; however, to the best of our knowledge, the evidence base supporting this has been limited. It is important to note at the outset that the majority of the cannabis research conducted in oncology patients lacks the rigor that would be required of most other oncology treatments in practice. Even the limited number of randomized controlled trials that exist for comparing the efficacy of cannabis with that of placebo or other drugs in oncologic patients are homogeneously low or very low in quality. 11 A recent systematic review characterized the available evidence regarding cannabis for cancer symptom management as low quality and found no benefit for its common indications of pain, sleep, or a reduction of opioid dose. 12 In addition, to our knowledge, evidence for the antiemetic properties of plantbased preparations is seriously lacking. In effect, the best evidence exists for oral, pharmaceutically prepared, synthetic tetrahydrocannabinols (THCs) such as nabilone and dronabinol, which have been found to be superior to placebo and equivalent to other antiemetic medications. [13][14][15] For example, one observational prospective study found at least a 30% reduction in symptoms such as vomiting and fatigue ...

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Cannabis Impacts Tumor Response Rate to Nivolumab in Patients with Advanced Malignancies

Cited by 119 publications

References 28 publications

Expectations versus reality: Improvement of symptom control and quality of life of oncology patients using medical cannabis

Expectations versus reality: Improvement of symptom control and quality of life of oncology patients using medical cannabis

Cannabinoids in the Pathophysiology of Skin Inflammation

Medical cannabis use among individuals with cancer: An unresolved and timely issue

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