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Table 6 Cancer

From: Benefits and harms of medical cannabis: a scoping review of systematic reviews

Author, year Search dates; # databases searched Funding source Nstudies Illness/condition Intervention/comparator* Outcomes Conclusions from data AMSTAR-2 rating
van den Beuken-van Everdingen, 2017 [84] Jan 2005–May 2014; 3 NR 3 Cancer I: Plant-derived cannabinoids
C: placebo; THC alone
• Cancer pain: nociceptive pain, NP, and chemotherapy-induced pain
• Rate of adverse events
Only one study included CL
Tateo, 2017 [37] NR; 4 NR 8 Cancer I: Plant-based and plant-derived cannabinoids
C: Placebo; codeine; secobarbital; THC
• Pain
• Sleep disruption
• QoL
• Impression of global change
• Sensory function
• Withdrawal due to AEs
Favors intervention for pain with nabiximols (vs. placebo); reported SBS for all other interventions and outcomes. M
Smith, 2015 [40] Inception–Jan 2015; 5 Non-profit 23 Cancer I: Synthetic cannabinoids
C: Placebo; prochlorperazine; domperidone; metoclopramide
• Absence of nausea
• Absence of vomiting
• Absence of both nausea and vomiting
• participant preference
• Dysphoria
• Feeling high
• Sedation
• Withdrawal due to adverse events
• Dizziness
• Euphoria
• Hallucinations
• Postural hypotension
• Depression
• Withdrawal due to lack of efficacy
No statistically significant differences between groups for: absence of nausea, dysphoria, sedation, hallucinations, hypotension, depression, withdrawal due to lack of efficacy. Favors intervention for absence of vomiting, absence of nausea and vomiting, feeling high, withdrawal due to adverse events, dizziness, dysphoria, euphoria, patient preference
Note: mixed results based on several subgroup analyses
M
Phillips, 2010 [54] Inception to Feb or Mar 2008; 11 Non-profit 4 Cancer I: Plant-derived and synthetic cannabinoids
C: Prochlorperazine and metoclopramide; domperidone; prochlorperazine
• Nausea and vomiting Only one study included M
Machado Rocha, 2008 [60] Inception to Dec 2006; 5 NR 30 Cancer I: Synthetic cannabinoids
C: Placebo; neuroleptic drugs
• Anti-emetic efficacy
• Preference for drug
No statistically significant difference for anti-emetic effect of dronabinol vs. placebo, and nabilone or levonantradol vs. neuroleptics. Favors intervention for anti-emetic effect of dronabinol vs. neuroleptic and preference of drug. M
Yavuzsen, 2005 [79] Start search date varies by database to Oct 2004 NR 1 Cancer I: Plant-based cannabis alone or in combination with megestrol acetate
C: Megestrol acetate
• Weight
• Appetite
• QoL
Only one study included CL
The Belgian Health Care Knowledge Centre (KCE), 2012 [89] Dec 2011 to Aug 2012; 6 NR 4 Chemotherapy-related adverse events I: Plant-based cannabis and synthetic cannabinoids + chemo
C: Placebo (+ chemo)
• Complete response to anti-emetic therapy
• Absence of delayed nausea
• Significant delayed nausea
• Absence of delayed emesis
• QoL
• Nausea absence
• Vomiting and/or retching (mean number of episodes per week)
• Patient’s wellness
• At least one AE
• Severe AEs
• At least one treatment emerging AE
• At least one serious AE
Only one study narratively described for each outcome, except for AEs. No statistically significant difference between groups for at least one AE and severe AEs (cannabis vs. placebo.) Favors dronabinol for at least one treatment emerging AE. Favors placebo for at least one serious AE. M
American Society of Clinical Oncology, 2016 [88] Searched on Nov 5, 2014; 1 Non-profit 4 Cancer I: Plant-derived cannabinoids
C: Placebo
• Pain (NRS score)
• Worsening of nausea and vomiting
Only one study included L
SIGN, 2008 [87] 1997 to Jun 2007; 8 Government 3 Cancer I: Plant-based cannabis and plant-derived cannabinoids
C: Placebo
• NP
• Central NP
Favors intervention for NP (types of cannabis combined). Only one study included for NP (smoked cannabis) and central NP M
  1. AE adverse effect, NP neuropathic pain, NR not reported, NRS numerical rating scale, QoL quality of life, THC tetrahydrocannabinol, SIGN Scottish Intercollegiate Guidelines Network, SBS study-by-study
  2. *A colon indicates that there were separate analyses for each comparator; a “+” sign indicates placebo was combined with another comparator