Cannabinoids for symptom management in children with cancer: A systematic review and meta-analysis |
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Authors: | Manik Chhabra PharmD Mohamed Ben-Eltriki PhD MSc BSPS RPh Arun Paul PharmD Mê-Linh Lê MA MLIS Anthony Herbert MBBS BMedSci Sapna Oberoi DM MD Natalie Bradford PhD MPH BNur Alison Bowers PhD MClinRes BN S. Rod Rassekh MD MHSc Lauren E. Kelly PhD MSc BMedSci CCRP |
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Affiliation: | 1. Department of Pharmacology and Therapeutics, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada;2. Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada;3. Queensland Children’s Hospital, Children’s Health Queensland, Brisbane, Queensland, Australia Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, South Brisbane, Queensland, Australia;4. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada Department of Pediatric Hematology–Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada;5. Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, South Brisbane, Queensland, Australia;6. Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Manitoba, Canada |
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Abstract: | Background Despite the widespread use of medical cannabis, little is known regarding the safety, efficacy, and dosing of cannabis products in children with cancer. The objective of this study was to systematically appraise the existing published literature for the use of cannabis products in children with cancer. Methods This systematic review, registered with the International Prospective Register of Systematic Reviews (CRD42020187433), searched four databases: MEDLINE, Embase, PsycINFO, and the Cochrane Library. Abstracts and full texts were screened in duplicate. Data on types of cannabis products, doses, formulations, frequencies, routes of administration, indications, and clinical and demographic details as well as reported efficacy outcomes were extracted. Data on cannabinoid-related adverse events were also summarized. Results Out of 34,611 identified citations, 19 unique studies with a total of 1927 participants with cancer were included: eight retrospective chart reviews, seven randomized controlled trials, two open-label studies, and two case reports. The included studies reported the use of various cannabis products for the management of symptoms. Cannabinoids were commonly used for the management of chemotherapy-induced nausea and vomiting (11 of 19 [58%]). In controlled studies, somnolence, dizziness, dry mouth, and withdrawal due to adverse events were more commonly associated with the use of cannabinoids. Across all included studies, no serious cannabis-related adverse events were reported. Conclusions Although there is evidence to support the use of cannabis for symptom management, in children with cancer, there is a lack of rigorous evidence to inform the dosing, safety, and efficacy of cannabinoids. Because of the increasing interest in using cannabis, there is an urgent need for more research on medical cannabis in children with cancer. |
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Keywords: | cancer symptoms cannabidiol chemotherapy-induced nausea and vomiting children medical cannabis tetrahydrocannabinol |
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