There is some evidence to support the use of cannabis for symptom management in children with cancer, but there is a lack of evidence on the safety and efficacy of cannabinoids in this patient population, according to researchers.
“There is a strong need for interventional studies comparing the safety and efficacy of cannabinoids and available treatment options in children with cancer,” the researchers wrote in Cancer.
The researchers conducted a systematic review of trials with at least 1 child (18 or younger) who had cancer and was receiving any type of natural or pharmaceutical-grade cannabis for symptom management.
The analysis included 19 studies — 10 observational studies (n=1529) and 9 interventional studies (n=398). The median age of participants ranged from 6 months to 18 years in the observational studies and from 3.6 months to 18 years in the interventional studies.
Most patients in the observational studies (90%) had brain tumors, leukemia, or lymphoma. Cancer types were not specified in most of the interventional studies.
In 11 of the 19 studies (58%), cannabinoids were used for the management of chemotherapy-induced nausea and vomiting (CINV). The cannabinoids used included nabilone (26%), unspecified cannabis herbal extracts (26%), Δ‐9‐tetrahydrocannabinol (THC; 16%), dronabinol (11%), Δ‐8‐THC (5%), levonantradol (5%), unspecified cannabinoids (5%), and cannabidiol (CBD; 5%).
There were 7 interventional studies that reported efficacy outcomes, and cannabinoids were reportedly superior to active control groups for controlling CINV.
Patients also received cannabinoids for the management of cancer symptoms other than CINV (42%, 8 of 19 studies), but efficacy data were not provided for these studies.
The major cannabinoid‐related adverse events (AEs) reported in the observational studies were drowsiness, dizziness, headache, and euphoria. Cannabinoid‐related AEs reported in the interventional studies were somnolence, increased appetite, the development of a “high,” dizziness, and dry mouth.
“Evidence is urgently required on the safety of cannabinoids with respect to different cannabis products, tolerability, and doses of cannabinoids in the vulnerable pediatric population diagnosed with cancer,” the researchers wrote. “[T]here is scope for developing a core set of outcomes for cannabinoid clinical trials in pediatric oncology. Additionally, there is scope for pediatricians to collaborate internationally to generate long‐term safety and efficacy data for cannabinoids in children with cancer.”
Disclosures: Some study authors disclosed funding to research medicinal cannabis from various entities. Please see the original reference for a full list of disclosures.
Chhabra M, Ben-Eltriki M, Paul A, et al. Cannabinoids for symptom management in children with cancer: A systematic review and meta‐analysis. Cancer. Published online August 28, 2023. doi:10.1002/cncr.34920