Zeitschrift für Komplementärmedizin 2023; 15(06): 36-41
DOI: 10.1055/a-2188-1270
Praxis
Cannabis bei Krebs

Cannabinoide Arzneimittel bei Krebspatient*innen

Thomas Herdegen

Summary

Medikamente, die die therapeutisch relevanten Inhaltsstoffe des Cannabis, Tetrahydrocannabinol (THC) und Canabidiol (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.



Publication History

Article published online:
12 December 2023

© 2023. Thieme. All rights reserved.

© Karl F. Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co.
KG

 
  • Literatur

  • 1 Abrams D. Cannabis, Cannabinoids and cannabis-based medicines in cancer care. Integr Cancer Ther 2022; 21: 1-11 DOI: 10.1177/15347354221081772.
  • 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 DOI: 10.1016/j.ejim.2018.01.023.
  • 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 (09) 2447 DOI: 10.3390/cancers12092447.
  • 4 Böttge-Wolpers C, Bialas P, Gottschling S. et al Benefits and harms of cannabis-based medicines from the viewpoint of patients with chronic pain and their physicians: A cohort study in three pain centers of the German federal state Saarland. Schmerz. 2023 [online zuerst publiziert] DOI: 10.1007/s00482-022-00688-0
  • 5 Bridgeman MB, Abazia DT. Medicinal Cannabis: History, pharmacology, and implications for the acute care setting. PT 2017; 42: 180-188
  • 6 Bundesinstitut für Arzneimittel und Medizinprodukte. Abschlussbericht der Begleiterhebung nach § 31 Absatz 6 des Fünften Buches Sozialgesetzbuch zur Verschreibung und Anwendung von Cannabisarzneimittel. Begleiterhebung des BfArM (2022). Im Internet: file:///Users/juliabrandt/Downloads/Abschlussbericht_Begleiterhebung.pdf; Stand: 14.10.2023
  • 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 (01) 307 DOI: 10.3390/jcm12010307.
  • 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
  • 9 Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet 2003; 42: 327-360
  • 10 Hameed M, Prasad S, Jain E. et al Medical cannabis for chronic nonmalignant pain management. Curr Pain Headache Rep 2023; 27: 57-63
  • 11 Hasbi A, Madras BK, George SR. Endocannabinoid system and exogenous cannabinoids in depression and anxiety: A review. Brain Sci 2023; 13 (02) 325 DOI: 10.3390/brainsci13020325.
  • 12 Herdegen T, Cascorbi I. Arzneimittelinteraktionen von THC und CBD in cannabinoiden Arzneimitteln (CAM): Empfehlungen für die Praxis. Dt Ärztbl. 2023 [im Druck]
  • 13 Hinz B, Ramer R. Anti-tumour actions of cannabinoids. Br J Pharmacol 2019; 176: 1384-1394
  • 14 Hinz B, Ramer R. Cannabinoids as anticancer drugs: Current status of preclinical research. Br J Cancer 2022; 127: 1-13
  • 15 Horlemann J, Schürmann N.. DGS-Praxisleitlinie: Cannabis in der Schmerzmedizin (2022). Im Internet. https://dgs-praxisleitlinien.de/cannabis/ Stand: 14.10.2023
  • 16 Huestis MA. Human cannabinoid pharmacokinetics. Chem Biodivers 2007; 04: 1770-1804 DOI: 10.1002/cbdv.200790152.
  • 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 DOI: 10.1200/JCO.2002.20.2.567.
  • 18 Kendall DA, Yudowski GA. Cannabinoid receptors in the central nervous system: Their signaling and roles in disease. Front Cell Neurosci 2016; 10: 294 DOI: 10.3389/fncel.2016.00294.
  • 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; 08 (02) 360-370 DOI: 10.1002/epi4.12699.
  • 20 Lucas CJ, Galettis P, Schneider J. The pharmacokinetics and the pharmacodynamics of cannabinoids. Br J Clin Pharmacol 2018; 84: 2477-2482
  • 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 (09) 1034-1040 DOI: 10.1038/mp.2013.61.
  • 22 Rahaman O, Ganguly D. Endocannabinoids in immune regulation and immunopathologies. Immunology 2021; 16 04 (02) 242-252 DOI: 10.1111/imm.13378.
  • 23 Ramer R, Hinz B. Cannabinoids as anticancer drugs. Adv Pharmacol 2017; 80: 397-436
  • 24 Ramer R, Wittig F, Hinz B. The endocannabinoid system as a pharmacological target for new cancer therapies. Cancers (Basel) 2021; 13 (22) 5701 DOI: 10.3390/cancers13225701.
  • 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 (11) 649555 DOI: 10.3389/fonc.2021.649555.
  • 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
  • 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 (11) 1053-1067 DOI: 10.1007/s40263-018-0578-5.
  • 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
  • 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 DOI: 10.1093/pm/pnab263.
  • 30 Vučković S, Srebro D, Savić Vujović K. et al Cannabinoids and pain: New insights from old molecules. Frontiers in Pharmacology 2018; 09: 1259 DOI: 10.3389/fphar.2018.01259.
  • 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 DOI: 10.1177/1758835921990203.
  • 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
  • 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 DOI: 10.1007/s00482-019-00408-1.
  • 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 DOI: 10.1007/s10620-020-06195-5.
  • 35 Gastmeier K, Gastmeier A, Rottmann F. et al Cannabinoide reduzieren den Opioidverbrauch bei älteren Schmerzpatienten: Eine retrospektive Dreijahresauswertung einer ambulanten kassenärztlichen Praxis [Cannabinoids reduce opioid use in older patients with pain: Retrospective three-year analysis of data from a general practice]. Schmerz. 2023; 37 (01) 29-3 DOI: 10.1007/s00482-022-00642-0.