Established and potential therapeutic applications of cannabinoids in oncology

Abstract

Cannabis occurs naturally in the dried flowering or fruiting tops of the Cannabis sativa plant. Cannabis is most often consumed by smoking marihuana. Cannabinoids are the active compounds extracted from cannabis. Recently, there has been renewed interest in cannabinoids for medicinal purposes. The two proven indications for the use of the synthetic cannabinoid (dronabinol) are chemotherapy-induced nausea and vomiting and AIDS-related anorexia. Other possible effects that may prove beneficial in the oncology population include analgesia, antitumor effect, mood elevation, muscle relaxation, and relief of insomnia. Two types of cannabinoid receptors, CB1 and CB2, have been detected. CB1 receptors are expressed mainly in the central and peripheral nervous system. CB2 receptors are found in certain nonneuronal tissues, particularly in the immune cells. Recent discovery of both the cannabinoid receptors and endocannabinoids has opened a new era in research on the pharmaceutical applications of cannabinoids. The use of cannabinoids should be continued in the areas indicated, and further studies are needed to evaluate other potential uses in clinical oncology.

Cancer Cachexia: Traditional Therapies and Novel Molecular Mechanism-Based Approaches to Treatment

“…Megesterol acetate (MA), a synthetic derivative of progestogens is commonly used to treat cancer anorexia [20–24]. The potential mechanism of action of MA is believed to involve stimulation of appetite by both direct and indirect pathways affecting the metabolism and production of catabolic cytokines [24].…”

“…The potential mechanism of action of MA is believed to involve stimulation of appetite by both direct and indirect pathways affecting the metabolism and production of catabolic cytokines [24]. MA has been refined to be more bioavailable as a nanocrystal oral suspension, significantly shortening the time to clinical response.…”

“…Progestogens are also associated with a reduction in steroid hormones which results in decline in muscle mass, and an increase in fat mass [40]. These side effects in addition to lack of efficacy to increase lean body mass has tempered the routine use of MA for treatment of cancer anorexia [24]. …”

Evaluation of sex differences in cannabinoid dependence

“…Even before it was recently legalized for recreational use in two states in the U.S., cannabis was the most widely used illicit substance of abuse in the U.S. (Substance Abuse and Mental Health Services Administration, 2013). In addition, cannabis has been used therapeutically to treat a variety of ailments including chronic pain (Aggarwal et al, 2009), chemotherapy-induced nausea and vomiting (Walsh et al, 2003), and various neurological disorders (Williamson and Evans, 2000; Hill et al, 2012). Because recreational and therapeutic use of cannabinoids commonly involves chronic use, dependence may develop.…”

Cannabinoid Hyperemesis Syndrome: A Case Report of Cyclic Severe Hyperemesis and Abdominal Pain with Long-Term Cannabis Use

“…Cannabis use is associated with several short- and long-term side effects such as changes in mood, impaired memory, impaired attention, depression, and anxiety and it is correlated with schizophrenia [1, 2]. However, cannabis use also has a therapeutic dimension due to its antiemetic and appetite-enhancing effects that is why it is sometimes used as a treatment for oncological patients suffering from nausea, vomiting, and loss of appetite during or after chemotherapy [3, 4]. The Cannabinoid Hyperemesis Syndrome is rare and was first described in the year 2004 by Allen et al [5] and 2009 by Sontineni et al [6] who first tried to establish diagnostic criteria.…”