Advertisement

Cannabinoids in Patients with Nausea and Vomiting Associated with Malignancy and Its Treatments

  • Jose M. Garcia
    Affiliations
    Department of Medicine, Division of Gerontology & Geriatric Medicine, University of Washington School of Medicine, Seattle, Wash

    Geriatric Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, Wash
    Search for articles by this author
  • Tatyana A. Shamliyan
    Correspondence
    Requests for reprints should be addressed to Tatyana A. Shamliyan, MD, MS, Evidence-Based Medicine Center, Elsevier, 1600 JFK Blvd, Philadelphia, PA 19103.
    Affiliations
    Quality Assurance, Evidence-Based Medicine Center, Elsevier, Philadelphia, Pa
    Search for articles by this author
      Cannabis-based medications (cannabinoids) have been approved by the US Food and Drug Administration (FDA) for the treatment of adults with chemotherapy-induced nausea.
      • Whiting P.F.
      • Wolff R.F.
      • Deshpande S.
      • et al.
      Cannabinoids for medical use: a systematic review and meta-analysis.
      However, some guidelines do not recommend these drugs as a useful therapeutic option for patients with inadequate response to commonly used antiemetic agents.
      • Hesketh P.J.
      • Bohlke K.
      • Lyman G.H.
      • et al.
      Antiemetics: American Society of Clinical Oncology focused guideline update.
      • Takeuchi H.
      • Saeki T.
      • Aiba K.
      • et al.
      Japanese Society of Clinical Oncology clinical practice guidelines 2010 for antiemesis in oncology: executive summary.
      Reimbursement of cannabinoids for medical purposes varies across countries,
      • Tafelski S.
      • Hauser W.
      • Schafer M.
      Efficacy, tolerability, and safety of cannabinoids for chemotherapy-induced nausea and vomiting-a systematic review of systematic reviews.
      although patient satisfaction and adherence are high.
      • Bar-Sela G.
      • Avisar A.
      • Batash R.
      • Schaffer M.
      Is the clinical use of cannabis by oncology patients advisable?.
      • Waissengrin B.
      • Urban D.
      • Leshem Y.
      • Garty M.
      • Wolf I.
      Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience.
      We conducted a rapid review according to an a priori–developed protocol to examine the most current evidence about the benefits and harms of cannabinoids in patients with nausea and vomiting associated with malignancy and its treatments.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Whiting P.F.
        • Wolff R.F.
        • Deshpande S.
        • et al.
        Cannabinoids for medical use: a systematic review and meta-analysis.
        JAMA. 2015; 313: 2456-2473
        • Hesketh P.J.
        • Bohlke K.
        • Lyman G.H.
        • et al.
        Antiemetics: American Society of Clinical Oncology focused guideline update.
        J Clin Oncol. 2015; 34: 381-386
        • Takeuchi H.
        • Saeki T.
        • Aiba K.
        • et al.
        Japanese Society of Clinical Oncology clinical practice guidelines 2010 for antiemesis in oncology: executive summary.
        Int J Clin Oncol. 2015; 21: 1-12
        • Tafelski S.
        • Hauser W.
        • Schafer M.
        Efficacy, tolerability, and safety of cannabinoids for chemotherapy-induced nausea and vomiting-a systematic review of systematic reviews.
        Schmerz. 2016; 30: 14-24
        • Bar-Sela G.
        • Avisar A.
        • Batash R.
        • Schaffer M.
        Is the clinical use of cannabis by oncology patients advisable?.
        Curr Med Chem. 2014; 21: 1923-1930
        • Waissengrin B.
        • Urban D.
        • Leshem Y.
        • Garty M.
        • Wolf I.
        Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience.
        J Pain Symptom Manage. 2015; 49: 223-230
        • Hesketh P.J.
        • Kris M.G.
        • Basch E.
        • et al.
        Antiemetics: American Society of Clinical Oncology clinical practice guideline update.
        J Clin Oncol. 2017; 35: 3240-3261
        • Berger M.J.
        • Ettinger D.S.
        • Aston J.
        • et al.
        Antiemesis, version 2.2017 featured updates to the NCCN guidelines.
        J Natl Compr Canc Netw. 2017; 15: 883-893
        • Dupuis L.L.
        • Robinson P.D.
        • Boodhan S.
        • et al.
        Guideline for the Prevention and Treatment of Anticipatory Nausea and Vomiting due to Chemotherapy in Pediatric Cancer Patients.
        Pediatric Oncology Group of Ontario (POGO), Toronto, ON, Canada2014 (Available at:) (Accessed February 2018)
        • Jordan K.
        • Roila F.
        • Molassiotis A.
        • Maranzano E.
        • Clark-Snow R.A.
        • Feyer P.
        Antiemetics in children receiving chemotherapy. MASCC/ESMO guideline update 2009.
        Support Care Cancer. 2011; 19: S37-S42
        • Patel P.
        • Robinson P.D.
        • Thackray J.
        • et al.
        Guideline for the prevention of acute chemotherapy-induced nausea and vomiting in pediatric cancer patients: a focused update.
        Pediatr Blood Cancer. 2017; 64 (Available at:) (Accessed February 2018): e26542
        • de las Peñas R.
        • Blasco A.
        • De Castro J.
        • et al.
        SEOM Clinical Guideline update for the prevention of chemotherapy-induced nausea and vomiting (2016).
        Clin Transl Oncol. 2016; 18: 1237-1242
        • Smith L.A.
        • Azariah F.
        • Lavender V.T.
        • Stoner N.S.
        • Bettiol S.
        Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy.
        Cochrane Database Syst Rev. 2015; (CD009464)
        • Chang A.E.
        • Shiling D.J.
        • Stillman R.C.
        • et al.
        Delata-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate. A prospective, randomized evaluation.
        Ann Intern Med. 1979; 91: 819-824
        • Chang A.E.
        • Shiling D.J.
        • Stillman R.C.
        • et al.
        A prospective evaluation of delta-9-tetrahydrocannabinol as an antiemetic in patients receiving adriamycin and cytoxan chemotherapy.
        Cancer. 1981; 47: 1746-1751
        • Meiri E.
        • Jhangiani H.
        • Vredenburgh J.J.
        • et al.
        Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting.
        Curr Med Res Opin. 2007; 23: 533-543
        • National Cancer Institute and Solvay Pharmaceuticals
        Palonosetron and dexamethasone with or without dronabinol in preventing nausea and vomiting in patients receiving chemotherapy for cancer.
        (Available at) (Accessed February 2018)
        • Levitt M.
        Nabilone vs. placebo in the treatment of chemotherapy-induced nausea and vomiting in cancer patients.
        Cancer Treat Rev. 1982; 9: 49-53
        • Frytak S.
        • Moertel C.G.
        • O'Fallon J.R.
        • et al.
        Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo.
        Ann Intern Med. 1979; 91: 825-830
        • Sallan S.E.
        • Zinberg N.E.
        • Frei 3rd., E.
        Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy.
        N Engl J Med. 1975; 293: 795-797
        • Wada J.K.
        • Bogdon D.L.
        • Gunnell J.C.
        • Hum G.J.
        • Gota C.H.
        • Rieth T.E.
        Double-blind, randomized, crossover trial of nabilone vs. placebo in cancer chemotherapy.
        Cancer Treat Rev. 1982; 9: 39-44
        • Duran M.
        • Perez E.
        • Abanades S.
        • et al.
        Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting.
        Br J Clin Pharmacol. 2010; 70: 656-663
        • Jones S.E.
        • Durant J.R.
        • Greco F.A.
        • Robertone A.
        A multi-institutional phase III study of nabilone vs. placebo in chemotherapy-induced nausea and vomiting.
        Cancer Treat Rev. 1982; 9: 45-48
        • Ahmedzai S.
        • Carlyle D.L.
        • Calder I.T.
        • Moran F.
        Anti-emetic efficacy and toxicity of nabilone, a synthetic cannabinoid, in lung cancer chemotherapy.
        Br J Cancer. 1983; 48: 657-663
        • Johansson R.
        • Kilkku P.
        • Groenroos M.
        A double-blind, controlled trial of nabilone vs. prochlorperazine for refractory emesis induced by cancer chemotherapy.
        Cancer Treat Rev. 1982; 9: 25-33
        • Lane M.
        • Vogel C.L.
        • Ferguson J.
        • et al.
        Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting.
        J Pain Symptom Manage. 1991; 6: 352-359
        • Niiranen A.
        • Mattson K.
        A cross-over comparison of nabilone and prochlorperazine for emesis induced by cancer chemotherapy.
        Am J Clin Oncol. 1985; 8: 336-340
        • Herman T.S.
        • Einhorn L.H.
        • Jones S.E.
        • et al.
        Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy.
        N Engl J Med. 1979; 300: 1295-1297
        • McCabe M.
        • Smith F.P.
        • Macdonald J.S.
        • Woolley P.V.
        • Goldberg D.
        • Schein P.S.
        Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy.
        Invest New Drugs. 1988; 6: 243-246
        • Einhorn L.H.
        • Nagy C.
        • Furnas B.
        • Williams S.D.
        Nabilone: an effective antiemetic in patients receiving cancer chemotherapy.
        J Clin Pharmacol. 1981; 21: 64S-69S
        • Steele N.
        • Gralla R.J.
        • Braun Jr, D.W.
        • Young C.W.
        Double-blind comparison of the antiemetic effects of nabilone and prochlorperazine on chemotherapy-induced emesis.
        Cancer Treat Rep. 1980; 64: 219-224
        • Crawford S.M.
        • Buckman R.
        Nabilone and metoclopramide in the treatment of nausea and vomiting due to cisplatinum: a double blind study.
        Med Oncol Tumor Pharmacother. 1986; 3: 39-42
        • George M.
        • Pejovic M.H.
        • Thuaire M.
        • Kramar A.
        • Wolff J.P.
        [Randomized comparative trial of a new anti-emetic: nabilone, in cancer patients treated with cisplatin].
        Biomed Pharmacother. 1983; 37: 24-27
        • Pomeroy M.
        • Fennelly J.J.
        • Towers M.
        Prospective randomized double-blind trial of nabilone versus domperidone in the treatment of cytotoxic-induced emesis.
        Cancer Chemother Pharmacol. 1986; 17: 285-288
        • Gralla R.J.
        • Tyson L.B.
        • Bordin L.A.
        • et al.
        Antiemetic therapy: a review of recent studies and a report of a random assignment trial comparing metoclopramide with delta-9-tetrahydrocannabinol.
        Cancer Treat Rep. 1984; 68: 163-172
        • Phillips R.S.
        • Gopaul S.
        • Gibson F.
        • et al.
        Antiemetic medication for prevention and treatment of chemotherapy induced nausea and vomiting in childhood.
        Cochrane Database Syst Rev. 2010; (CD007786)
        • Kleinman S.
        • Weitzman S.
        • Cassem N.
        • Andrews E.
        Double-blind trial of delta-9-tetrahydrocannabinol (THC) versus placebo as an adjunct to prochlorperazine for chemotherapy-induced vomiting.
        Curr Ther Res Clin Exp. 1983; 33: 1014-1017
        • Long A.
        • Mioduszewski J.
        • Natale R.
        A randomized double-blind cross-over comparison of the antiemetic activity of levonantradol and prochlorperazine.
        Proc Am Soc Clin Oncol. 1982; 1: C-220
        • Veeda Oncology
        A Phase IV Trial of Cesamet™ Given With Standard Antiemetic Therapy for Chemotherapy-induced Nausea and Vomiting.
        (Available at:) (Accessed February 2018)
        • Solvay Pharmaceuticals
        Dronabinol Versus Standard Ondansetron Antiemetic Therapy in Preventing Delayed-Onset Chemotherapy-Induced Nausea and Vomiting.
        (Available at:) (Accessed February 2018)
        • Tafelski S.
        • Häuser W.
        • Schäfer M.
        Efficacy, tolerability, and safety of cannabinoids for chemotherapy-induced nausea and vomiting—a systematic review of systematic reviews.
        Schmerz. 2016; 30: 14-24
        • Wong S.S.
        • Wilens T.E.
        Medical cannabinoids in children and adolescents: a systematic review.
        Pediatrics. 2017; 140https://doi.org/10.1542/peds.2017-1818
        • Kramer J.L.
        Medical marijuana for cancer.
        CA Cancer J Clin. 2015; 65: 109-122
        • Ostadhadi S.
        • Rahmatollahi M.
        • Dehpour A.R.
        • Rahimian R.
        Therapeutic potential of cannabinoids in counteracting chemotherapy-induced adverse effects: an exploratory review.
        Phytother Res. 2015; 29: 332-338