Patients with or without cancer use different forms of marijuana

March 26, 2019

NYU Langone Health / NYU School of Medicine

People with and without cancer are more likely, over time, to use a more potent form of medical marijuana with increasingly higher amounts of tetrahydrocannabinol (THC), a new study shows.

In a report publishing in the Journal of Palliative Medicine on March 26, researchers say that cancer patients were more likely to favor forms of medical marijuana with higher amounts of THC, which relieves cancer symptoms and the side effects of cancer treatment, including chronic pain, weight loss, and nausea.

By contrast, marijuana formulations higher in cannabidiol (CBD), which has been shown to reduce seizures and inflammation in other studies, were more popular among non-cancer patients, including those with epilepsy and multiple sclerosis, say the study authors.

Cancer patients were also more likely to prefer taking oil droplets containing medical marijuana under the tongue than "vaping."

"Although there is growing patient interest in medical cannabis, there is a scarcity of solid evidence about the benefits, risks, and patterns of use of marijuana products in various disease settings," says study lead investigator Arum Kim, MD, an assistant professor of medicine and rehabilitation medicine at NYU School of Medicine and director of the supportive oncology program at its Perlmutter Cancer Center. "Such information is important for delivering the best care."

Since 1996, 31 states, including New York in 2014, have legalized medical marijuana.

For the study, researchers analyzed data from 11,590 men and women in New York, of whom 1,990 (17.2 percent of the total patient cohort) were cancer patients who purchased and used cannabis products from Columbia Care LLC., a dispensary licensed in New York State, between January 2016 and December 2017.

The researchers caution that their data did not include the type of cancer the purchasers had, how much of what they bought was used, or whether marijuana was used for symptoms unrelated to the cancer. Nevertheless, the patterns of use among cancer patients were distinctly different from those of non-cancer patients.

Specifically, the study found that cancer and non-cancer patients used different dosages of cannabis formulations with dramatically different THC:CBD ratios. The two most common formulations contained THC and CBD, but one had twenty times more THC than CBD, whereas the other had the opposite ratio.

Over the two years of the study, the research team found that all types of patients increased their THC dose by approximately 0.20 milligrams per week.

"Our study provides valuable new information about how cancer patients are using marijuana," says study senior investigator Benjamin Han, MD, MPH, an assistant professor of medicine and population health at NYU School of Medicine. "In the absence of strong clinical research data for medical marijuana, identifying patterns of use offers some sense of how to guide patients who come in with questions for using medical marijuana, and what may or may not help them."

Researchers say they next plan to get more detailed information about how medical marijuana affects patient response to therapy and functional status at different stages of their disease, as well as the risks and side effects of treatment. Furthermore, the profiles of other cannabinoids besides THC and CBD in medical marijuana products warrant further research, according to the study authors.

Along with Kim and Han, another co-author from NYU School of Medicine and Perlmutter Cancer Center, which funded the study, was Zujun Li, MD. Other study authors include Christopher Kaufmann, PhD, MHS, at University of California San Diego; and Roxanne Ko, BA, BS, at the University of Hawaii.

https://www.sciencedaily.com/releases/2019/03/190326081343.htm

Cannabinoids used in sequence with chemotherapy are a more effective treatment for cancer

June 5, 2017

Science Daily/University of St George's London

New research has confirmed that cannabinoids -- the active chemicals in cannabis -- are effective in killing leukemia cells, particularly when used in combination with chemotherapy treatments.

Researchers also found that sequential use of an initial dose of chemotherapy first and then cannabinoids significantly improved overall results against the blood cancer cells. They found that combining existing chemotherapy treatments with cannabinoids had better results than chemotherapy alone, meaning that a similar level of effect could be achieved through using a lower dose of the chemotherapy.

If this were translated to humans, this lower dose of chemotherapy would mean that the side-effects of chemotherapy could be lessened.

In a study led by Dr Wai Liu at St George's, University of London, said: "We have shown for the first time that the order in which cannabinoids and chemotherapy are used is crucial in determining the overall effectiveness of this treatment.

"These extracts are highly concentrated and purified, so smoking marijuana will not have a similar effect. But cannabinoids are a very exciting prospect in oncology, and studies such as ours serve to establish the best ways that they should be used to maximise a therapeutic effect."

Cannabinoids are the active chemicals in cannabis, known more specifically as phytocannabinoids. When extracted from the plant and purified, they have been shown to possess anticancer properties, especially in certain cancers of the brain.

Researchers looked at cancer cells in the laboratory, trying different combinations of cannabinoids against leukemia cells. They tested whether existing chemotherapy treatments worked effectively alongside the cannabinoids, and whether using the drugs in a different order had an effect.

A number of clinical studies are underway that are assessing the full potential of cannabinoids in patients with cancer. Researchers say more trials need to be carried out to establish the voracity of the claims.

https://www.sciencedaily.com/releases/2017/06/170605085559.htm