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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