Download PDF
Zeitschrift für Phytotherapie 2024; 45(01): 22-27
DOI: 10.1055/a-2260-9416
Forschung

Cannabinoide Arzneimittel bei Krebspatient*innen

Cannabinoid pharmaceuticals for cancer patients
Thomas Herdegen
1   Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum Schleswig-Holstein, Kiel
› Author Affiliations
› Further Information
    Permissions and Reprints

Zusammenfassung

Medikamente, die die therapeutisch relevanten Inhaltsstoffe des Cannabis, Tetrahydrocannabinol (THC) und Cannabidiol (CBD), enthalten, kommen bei Krebspatient*innen zum Einsatz, um zum Beispiel Krankheitssymptome wie Schmerzen oder Nebenwirkungen der Therapien zu lindern sowie die Lebensqualität zu verbessern. Die Studienlage rechtfertigt die Anwendung von cannabinoiden Arzneimitteln als Add-on-Therapie bei einem Total-Pain-Syndrom sowie Übelkeit, Appetitlosigkeit, Schlaflosigkeit, erhöhtem Muskeltonus, Stress, depressiven Verstimmungen, Ängstlichkeit und fehlender Distanzierung zum Krankheitsgeschehen. Erste Hinweise deuten zudem auf eine mögliche Anti-Tumor-Wirkung dieser Arzneimittel hin.

Abstract

Medications containing the therapeutically relevant ingredients of cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD), are used in cancer patients, for example to alleviate symptoms such as pain or side effects of therapies and to improve quality of life. Research findings justify the use of cannabinoid medicines as an add-on therapy for total pain syndrome, nausea, loss of appetite, insomnia, increased muscle tone, stress, depressive moods, anxiety and lack of detachment from the disease. Initial indications also point to a possible anti-tumour effect of these drugs.

Schlüsselwörter

Krebs - Krebstherapie - Onkologie - Cannabis - THC - CBD

Key words

Cancercancer therapy - oncology - cannabis - THC - CBD


Publication History

Article published online:
26 February 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Abrams DI. Cannabis, Cannabinoids and cannabis-based medicines in cancer care. Integr Cancer Ther 2022; 21: 1-11
    CrossrefPubMedSearch in Google Scholar
  • 2 Bar-Lev Schleider L, Mechoulam R, Lederman V. et al. Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer. Eur J Intern Med 2018; 49: 37-43
    CrossrefPubMedSearch in Google Scholar
  • 3 Bar-Sela G, Cohen I, Campisi-Pinto S. et al. Cannabis consumption used by cancer patients during immunotherapy correlates with poor clinical outcome. Cancers (Basel) 2020; 12: 2447
    CrossrefPubMedSearch in Google Scholar
  • 4 Böttge-Wolpers C, Bialas P, Gottschling S. et al Nutzen und Schaden von Cannabisarzneimitteln aus Sicht von Patienten mit chronischen Schmerzen und ihren Ärzten: Eine Kohortenstudie in drei saarländischen Schmerzzentren. Schmerz 2023; [online zuerst publiziert]
    CrossrefPubMedSearch in Google Scholar
  • 5 Bridgeman MB, Abazia DT. Medicinal cannabis: History. pharmacology, and implications for the acute care setting. PT 2017; 42: 180-188
    PubMedSearch in Google Scholar
  • 6 Bundesinstitut für Arzneimittel und Medizinprodukte. Abschlussbericht der Begleiterhebung nach § 31 Absatz 6 des Fünften Buches Sozialgesetzbuch zur Verschreibung und Anwendung von Cannabisarzneimittel. Bonn: BfArM; 06.07.2022. Im Internet: https://www.bfarm.de/SharedDocs/Downloads/DE/Bundesopiumstelle/Cannabis/Abschlussbericht_Begleiterhebung.pdf?__blob=publicationFile; Stand: 01.02.2024
  • 7 Christensen C, Allesø M, Rose M. et al. Clinical research evidence supporting administration and dosing recommendations of medicinal cannabis as analgesic in cancer patients. J Clin Med 2022; 12: 307
    CrossrefPubMedSearch in Google Scholar
  • 8 Grimison P, Mersiades A, Kirby A. et al. Oral THC: CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: A randomised, placebo-controlled, phase II crossover trial. Ann Oncol 2020; 31: 1553-1560
    CrossrefPubMedSearch in Google Scholar
  • 9 Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet 2003; 42: 327-360
    CrossrefPubMedSearch in Google Scholar
  • 10 Hameed M, Prasad S, Jain E. et al. Medical cannabis for chronic nonmalignant pain management. Curr Pain Headache Rep 2023; 27: 57-63
    CrossrefPubMedSearch in Google Scholar
  • 11 Hasbi A, Madras BK, George SR. Endocannabinoid system and exogenous cannabinoids in depression and anxiety: A review. Brain Sci 2023; 13: 325
    CrossrefPubMedSearch in Google Scholar
  • 12 Herdegen T, Cascorbi I. Arzneimittelinteraktionen von THC und CBD in cannabinoiden Arzneimitteln (CAM): Empfehlungen für die Praxis. Dt Ärztebl 2023; 120: 833-840
    CrossrefPubMedSearch in Google Scholar
  • 13 Hinz B, Ramer R. Anti-tumour actions of cannabinoids. Br J Pharmacol 2019; 176: 1384-1394
    CrossrefPubMedSearch in Google Scholar
  • 14 Hinz B, Ramer R. Cannabinoids as anticancer drugs: Current status of preclinical research. Br J Cancer 2022; 127: 1-13
    CrossrefPubMedSearch in Google Scholar
  • 15 Horlemann J, Schürmann N. DGS-Praxisleitlinie: Cannabis in der Schmerzmedizin. 2022 Im Internet https://dgs-praxisleitlinien.de/cannabis; Stand: 14.10.2023
    PubMedSearch in Google Scholar
  • 16 Huestis MA. Human cannabinoid pharmacokinetics. Chem Biodivers 2007; 04: 1770-1804
    CrossrefPubMedSearch in Google Scholar
  • 17 Jatoi A, Windschitl HE, Loprinzi CL. et al. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: A North Central Cancer Treatment Group study. J Clin Oncol 2002; 20: 567-573
    CrossrefPubMedSearch in Google Scholar
  • 18 Kendall DA, Yudowski GA. Cannabinoid receptors in the central nervous system: Their signaling and roles in disease. Front Cell Neurosci 2016; 10: 294
    CrossrefPubMedSearch in Google Scholar
  • 19 Kühne F, Becker LL, Bast T. et al. Real-world data on cannabidiol treatment of various epilepsy subtypes: A retrospective, multicenter study. Epilepsia Open 2023; 8: 360-370
    CrossrefPubMedSearch in Google Scholar
  • 20 Lucas CJ, Galettis P, Schneider J. The pharmacokinetics and the pharmacodynamics of cannabinoids. Br J Clin Pharmacol 2018; 84: 2477-2482
    CrossrefPubMedSearch in Google Scholar
  • 21 Neumeister A, Normandin MD. et al. Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: A positron emission tomography study. Mol Psychiatry 2013; 18: 1034-1040
    CrossrefPubMedSearch in Google Scholar
  • 22 Rahaman O, Ganguly D. Endocannabinoids in immune regulation and immunopathologies. Immunology 2021; 164: 242-252
    CrossrefPubMedSearch in Google Scholar
  • 23 Ramer R, Hinz B. Cannabinoids as anticancer drugs. Adv Pharmacol 2017; 80: 397-436
    CrossrefPubMedSearch in Google Scholar
  • 24 Ramer R, Wittig F, Hinz B. The endocannabinoid system as a pharmacological target for new cancer therapies. Cancers (Basel) 2021; 13: 5701
    CrossrefPubMedSearch in Google Scholar
  • 25 Schloss J, Lacey J, Sinclair J. et al. A phase 2 randomised clinical trial assessing the tolerability of two different ratios of medicinal cannabis in patients with high grade gliomas. Front Oncol 2021; 21: 649555
    CrossrefPubMedSearch in Google Scholar
  • 26 Stout SM, Cimino NM. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: A systematic review. Drug Metab Rev 2014; 46: 86-95
    CrossrefPubMedSearch in Google Scholar
  • 27 Taylor L, Gidal B, Blakey G. et al. A phase I, randomized, double-blind, placebo-controlled, single ascending dose, multiple dose, and food effect trial of the safety, tolerability and pharmacokinetics of highly purified cannabidiol in healthy subjects. CNS Drugs 2018; 32: 1053-1067
    CrossrefPubMedSearch in Google Scholar
  • 28 Twelves C, Sabel M, Checketts D. et al. A phase 1b randomised, placebo-controlled trial of nabiximols cannabinoid oromucosal spray with temozolomide in patients with recurrent glioblastoma. Br J Cancer 2021; 124: 1379-1387
    CrossrefPubMedSearch in Google Scholar
  • 29 Ueberall MA, Vila Silván C, Essner U. et al. Effectiveness, safety, and tolerability of nabiximols oromucosal spray vs typical oral long-acting opioid analgesics in patients with severe neuropathic back pain: Analysis of 6-month real-world data from the German pain e-registry. Pain Med 2022; 23: 745-760
    CrossrefPubMedSearch in Google Scholar
  • 30 Vučković S, Srebro D, Savić Vujović K. et al. Cannabinoids and pain: New insights from old molecules. Front Pharmacol 2018; 9: 1259
    CrossrefPubMedSearch in Google Scholar
  • 31 Waissengrin B, Mirelman D, Pelles S. et al. Effect of cannabis on oxaliplatin-induced peripheral neuropathy among oncology patients: A retrospective analysis. Ther Adv Med Oncol 2021; 13: 1758835921990203
    CrossrefPubMedSearch in Google Scholar
  • 32 Ward SJ, McAllister SD, Kawamura R. et al. Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT(1A) receptors without diminishing nervous system function or chemotherapy efficacy. Br J Pharmacol 2014; 171: 636-645
    CrossrefPubMedSearch in Google Scholar
  • 33 Wendelmuth C, Wirz S, Torontali M. et al. Dronabinol bei geriatrischen Schmerz- und Palliativpatienten: Eine retrospektive Auswertung der ambulanten kassenärztlichen Therapie. Schmerz 2019; 33: 384-391
    CrossrefPubMedSearch in Google Scholar
  • 34 Zikos TA, Nguyen L, Kamal A. et al. Marijuana, ondansetron, and promethazine are perceived as most effective treatments for gastrointestinal nausea. Dig Dis Sci 2020; 65: 3280-3286
    CrossrefPubMedSearch in Google Scholar
  • 35 Gastmeier K, Gastmeier A, Rottmann F. et al. Cannabinoide reduzieren den Opioidverbrauch bei älteren Schmerzpatienten: Eine retrospektive Dreijahresauswertung einer ambulanten kassenärztlichen Praxis. Schmerz 2023; 37: 29-37
    CrossrefPubMedSearch in Google Scholar