MASCC guideline: cannabis for cancer-related pain and risk of harms and adverse events

To, Josephine; Davis, Mellar P.; Sbrana, Andrea; Alderman, Bryony; Hui, David; Mukhopadhyay, Sandip; Bouleuc, Carole; Case, Amy A.; Amano, Koji; Crawford, Gregory P.; Feo, Giulia De; Tanco, Kimberson; Garsed, Jessica

doi:10.1007/s00520-023-07662-1

Cited by 22 publications

(29 citation statements)

References 81 publications

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“…21,26,[41][42][43] After the completion of the literature search, the Multinational Association for Supportive Care in Cancer (MASCC) published two additional cannabis systematic reviews, one on psychological symptoms 33 and one on cancer pain. 44 These publications were added to the current review.…”

Section: Characteristics Of Studies Identified In the Literature Searchmentioning

confidence: 99%

“…A 2023 MASCC guideline nonetheless recommended against cannabinoids for any indication among adults with cancer receiving a checkpoint inhibitor. 44 Clinical interpretation. Discordance between the Expert Panel's recommendation against cannabis and/or cannabinoids as an anticancer treatment and the plethora of anecdotes supporting their use warrants discussion.…”

Section: Clinical Interpretationmentioning

confidence: 99%

“…27 The 2023 MASCC guideline on cancer-related pain does not recommend cannabinoids for cancer pain outside of an RCT. 44 Sleep. A 2022 meta-analysis evaluated cannabinoids and sleep among adults with cancer pain, noncancer pain, or other conditions.…”

Section: Recommendation 32mentioning

confidence: 99%

“…A 2023 MASCC guideline nonetheless recommended against cannabinoids for any indication among adults with cancer receiving a checkpoint inhibitor. 44…”

Section: Recommendationsmentioning

confidence: 99%

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Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Braun,

Bohlke,

Abrams

et al. 2024

JCO

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PURPOSE To guide clinicians, adults with cancer, caregivers, researchers, and oncology institutions on the medical use of cannabis and cannabinoids, including synthetic cannabinoids and herbal cannabis derivatives; single, purified cannabinoids; combinations of cannabis ingredients; and full-spectrum cannabis. METHODS A systematic literature review identified systematic reviews, randomized controlled trials (RCTs), and cohort studies on the efficacy and safety of cannabis and cannabinoids when used by adults with cancer. Outcomes of interest included antineoplastic effects, cancer treatment toxicity, symptoms, and quality of life. PubMed and the Cochrane Library were searched from database inception to January 27, 2023. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS The evidence base consisted of 13 systematic reviews and five additional primary studies (four RCTs and one cohort study). The certainty of evidence for most outcomes was low or very low. RECOMMENDATIONS Cannabis and/or cannabinoid access and use by adults with cancer has outpaced the science supporting their clinical use. This guideline provides strategies for open, nonjudgmental communication between clinicians and adults with cancer about the use of cannabis and/or cannabinoids. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. Cannabis and/or cannabinoids may improve refractory, chemotherapy-induced nausea and vomiting when added to guideline-concordant antiemetic regimens. Whether cannabis and/or cannabinoids can improve other supportive care outcomes remains uncertain. This guideline also highlights the critical need for more cannabis and/or cannabinoid research. Additional information is available at www.asco.org/supportive-care-guidelines .

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Section: Characteristics Of Studies Identified In the Literature Searchmentioning

confidence: 99%

Section: Clinical Interpretationmentioning

confidence: 99%

Section: Recommendation 32mentioning

confidence: 99%

“…A 2023 MASCC guideline nonetheless recommended against cannabinoids for any indication among adults with cancer receiving a checkpoint inhibitor. 44…”

Section: Recommendationsmentioning

confidence: 99%

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Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Braun,

Bohlke,

Abrams

et al. 2024

JCO

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“…Insgesamt verwundert es jedoch nicht, dass die European Society for Medical Oncology (ESMO) die Wirksamkeit von Nabiximols als "unclear" einstuft und die EFIC den Einsatz bei Tumorschmerzen lediglich als individuellen Heilversuch rechtfertigt [15,18]. Nach einer Analyse der vorliegenden randomisierten Studien hat sich die Multinational Association Of Supportive Care In Cancer (MASCC) kürzlich gegen eine Empfehlung von Cannabis in der Therapie von Tumorschmerzen ausgesprochen [52]. Die aktuelle S3-Leitlinie der Palliativmedizin nimmt bislang keine Stellung in Bezug auf Cannabinoide in der Analgesie.…”

Section: Die Cannabis-indikationen In Der Onkologieunclassified

Cannabis in der Onkologie – viel Rauch um nichts?

Burkhard-Meier,

Rémi,

Lindner

et al. 2023

TumorDiagnostik & Therapie

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ZusammenfassungDie medizinische Verwendung von Cannabis hat in den letzten Jahren in Europa und Nordamerika an Popularität gewonnen. Cannabinoide sind sowohl als Fertigarzneimittel als auch in Blüten- und Extraktform verfügbar. Der vorliegende Artikel legt den Fokus auf die supportive Therapie onkologischer Patienten. Mögliche Indikationen sind Schmerzen, Chemotherapie-bedingte Übelkeit und Erbrechen, Appetitlosigkeit und Geschmacksveränderungen. Trotz des enormen Hypes um Cannabis als Medizin ist die Evidenz für dessen Anwendung bei onkologischen Patienten unzureichend. Palliativpatienten mit refraktären Symptomen könnten jedoch geeignete Kandidaten für einen Therapieversuch darstellen. Der entscheidende Parameter für die Auswahl eines Cannabis-Arzneimittels ist die THC/CBD-Ratio. Orale Einnahmeformen bieten sich gerade für Cannabis-naive und ältere Patienten an. Psychische und kardiovaskuläre Nebenwirkungen sind nicht zu unterschätzen.

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Study of the relationship between psychoactive substance use and pain in cancer patients and cancer survivors: A French nationwide cross‐sectional study

Ragusa,

Pereira,

Balayssac

2024

Intl Journal of Cancer

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Pain is a prevalent symptom among cancer patients and survivors. Psychoactive substance use (PSU) is associated with both the presence and severity of pain. However, little is known about this association in the context of cancer. The primary objective was to compare the prevalence of PSU and its relationship with pain during and after cancer. PSU was defined as the use of nonmedication substances (alcohol, tobacco, e‐cigarettes, cannabidiol, and cannabis), with frequency categorized as at least yearly, monthly, weekly, or daily. Secondary objectives aimed to explore the relationships between PSU and pain characteristics, health‐related quality of life, anxiety, depression, deprivation, and individual characteristics. Among the 1041 individuals included, pain prevalence was 44.7% (95% confidence interval [CI] 41.6%–47.8%). The overall prevalence of PSU at least monthly was 67.0% (95% CI 64.0%–69.8%). The proportions of chronic and neuropathic pains were higher for at least monthly use of cannabidiol compared to nonuse (70.0% vs. 39.3% and 55.7% vs. 28.1%, p < .001). In multivariate analysis, the monthly uses of tobacco and cannabidiol were higher in painful individuals than in nonpainful ones (odds ratio: 2.85 [95% CI 1.22–6.64] and 3.76 [95% CI 1.13–12.44], p < .05). From the point of view of the patient care, the study underscores the need for physicians to prioritize smoking cessation and pay attention to the use of cannabidiol during and after cancer.

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MASCC guideline: cannabis for cancer-related pain and risk of harms and adverse events

Cited by 22 publications

References 81 publications

Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline

Cannabis in der Onkologie – viel Rauch um nichts?

Study of the relationship between psychoactive substance use and pain in cancer patients and cancer survivors: A French nationwide cross‐sectional study

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