Evidence lacking about efficacy, safety of cannabis products for children with cancer
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Key takeaways:
- Researchers identified 19 studies on the use of cannabis that included children with cancer.
- These products most frequently were used for management of chemotherapy-induced nausea and vomiting.
Despite increased interest in use of medical cannabis to alleviate cancer symptoms, there is limited rigorous evidence about the efficacy and safety of these products for pediatric patients, a systematic review and meta-analysis showed.
Additional research is needed to understand the impact of cannabinoids for children given use of these products is increasing among children, study authors concluded.
“There is an urgent need for efficient multi-jurisdictional collaborations to conduct innovative clinical trials and observational studies investigating cannabis-based products used for symptom management in children with cancer,” Lauren E. Kelly, PhD, MSc, BMedSci, CCRP, associate professor in the department of pharmacology and therapeutics at University of Manitoba, told Healio. “Without this critical data, clinicians and families are left without answers on long-term safety, efficacy and the impact of cannabinoids on families’ quality of life.”
Methodology
Kelly and colleagues searched published articles in four databases — MEDLINE, Embase, PsycINFO and Cochrane Library — for published literature related to the use of cannabis products by children with cancer.
Researchers examined data about cannabis product types, doses, formulations, frequencies, routes of administration and indications. They also obtained clinical and demographic information, as well as any findings on efficacy outcomes and cannabinoid-related adverse events.
Researchers identified 19 unique studies that included a combined 1,927 individuals with cancer. The studies included eight retrospective chart reviews, seven randomized controlled trials, two case reports and two open-label studies.
Results
Eleven (58%) of the 19 studies showed cannabinoids were used for management of chemotherapy-induced nausea and vomiting.
Researchers reported no serious cannabis-related adverse events. However, data from controlled studies showed several types of adverse events — including excessive sleepiness, dizziness and dry mouth — were more commonly associated with use of cannabinoids. Withdrawal from treatment due to adverse events also was more common among those who used cannabinoids.
Next steps
Although some data support cannabis use for cancer symptom management, rigorous evidence to inform dosing, efficacy and safety of cannabinoids for children with cancer is lacking Kelly and colleagues concluded.
More research is needed to better inform oncologists, patients and their families, researchers added.
“We were surprised to see a wide variety of cannabis-based products were used for symptom management [among] children with cancer despite a lack of solid evidence supporting the safety and efficacy in children,” Kelly told Healio.
The systematic review and meta-analysis also “revealed a historical perspective” on cannabinoid use in pediatric oncology, Kelly said, adding it is “noteworthy” that trials exploring use of cannabis-based products for pediatric populations date to the 1980s.
“Cannabis-based products may be beneficial in managing symptoms in children with cancer, especially where there is a failure to respond to currently available therapies,” Kelly said. “However, there is no evidence to determine the dosing, safety and effectiveness of most cannabis-containing products for managing symptoms experienced by children with cancer. Our most important finding is the urgency for which more research is needed to support these families.”
For more information:
Lauren E. Kelly, PhD, MSc, BMedSci, CCRP, can be reached at Department of Pharmacology and Therapeutics, Max Rady College of Medicine, University of Manitoba, 753 McDermot Ave., Winnipeg, MB R3E0T6, Canada; email: lauren.kelly@umanitoba.ca.
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