Multinational Association of Supportive Care in Cancer (MASCC) expert opinion/consensus guidance on the use of cannabinoids for gastrointestinal symptoms in patients with cancer

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

doi:10.1007/s00520-022-07480-x

Cited by 21 publications

(22 citation statements)

References 39 publications

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“…A total of 366 publications were identified in the literature search. After applying the eligibility criteria, 16 remained: 11 systematic reviews 24,25,[27][28][29][30]32,[37][38][39][40] and five RCTs or cohort studies not captured by the included systematic reviews. 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.…”

Section: Characteristics Of Studies Identified In the Literature Searchmentioning

confidence: 99%

“…The 2022 MASCC guideline on cannabinoids for GI symptoms in adults with cancer suggests against use of cannabinoids in the following circumstances: treatment of nausea and vomiting unrelated to chemotherapy; first-line treatment in the prevention of CINV; and prevention of radiotherapyinduced nausea and vomiting. 40 The MASCC guideline suggests that cannabinoids may be considered for refractory CINV in adults with cancer who are not on checkpoint inhibitors. 40 Radiation-induced nausea and vomiting.…”

Section: Recommendation 32mentioning

confidence: 99%

“…40 The MASCC guideline suggests that cannabinoids may be considered for refractory CINV in adults with cancer who are not on checkpoint inhibitors. 40 Radiation-induced nausea and vomiting. Fewer studies have addressed cannabis and/or cannabinoids in relation to nausea and vomiting in patients receiving radiotherapy.…”

Section: Recommendation 32mentioning

confidence: 99%

“…40 The MASCC guideline suggests that cannabinoids may be considered for refractory CINV in adults with cancer who are not on checkpoint inhibitors. 40…”

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: Recommendation 32mentioning

confidence: 99%

Section: Recommendation 32mentioning

confidence: 99%

“…40 The MASCC guideline suggests that cannabinoids may be considered for refractory CINV in adults with cancer who are not on checkpoint inhibitors. 40…”

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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“…Third, cannabis might improve appetite, although rigorous data with cannabis are sparse and not always highly compelling. A Multi-National Association of Supportive Care in Cancer expert opinion/consensus guide on the use of cannabinoids for gastrointestinal symptoms in patients with cancer was recently published 16▪ . This thoughtful, in-depth systematic review examined published studies between 1975 and 2021; interestingly, these authors reported that only four studies focused on loss of appetite and cannabis.…”

Section: An Update On Palliation Of Anorexiamentioning

confidence: 99%

Loss of appetite in patients with cancer: an update on characterization, mechanisms, and palliative therapeutics

Haemmerle¹,

Jatoi

2023

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review Over the past year, loss of appetite in patients with cancer has continued to be an area of active investigation. This review provides an update of recently published findings. Recent findings Despite the emergence of new cancer therapeutic agents, this symptom of loss of appetite continues to trouble patients, and it continues to be associated with poor survival. Recent preclinical research promises to lead to newer approaches and newer, more effective palliative agents. Recent clinical research shows that agents such as olanzapine, anamorelin, and cannabis either do or might palliate this symptom. Summary Loss of appetite in patients with cancer remains an important area of clinical and research focus. Recent published data provide greater clarity with respect to how to palliate this symptom. Today, although clinicians have more options to palliate cancer-associated loss of appetite than ever before, questions remain unanswered about how to palliate this symptom optimally and how to improve the quality of life of patients who suffer from it.

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