Download PDF
Deutsche Zeitschrift für Onkologie 2022; 54(04): 159-165
DOI: 10.1055/a-1947-1976
Forschung

Der Nutzen von Cannabis in der Krebstherapie

The Benefits of Cannabis in Cancer Therapy
Franjo Grotenhermen
1   Zentrum für Cannabismedizin, Steinheim
› Author Affiliations
› Further Information
    Permissions and Reprints

Zusammenfassung

Cannabis und Cannabinoide können bei der Palliation einer Anzahl von krebsassoziierten Symptomen hilfreich sein, darunter Appetitlosigkeit mit Gewichtsverlust, Übelkeit und Erbrechen, Schmerzen, Schlafstörungen und Depressionen. Einige dieser Indikationen gelten heute als etabliert. In der Grundlagenforschung wurde darüber hinaus nachgewiesen, dass eine Anzahl von Cannabinoiden, darunter THC (Dronabinol) und CBD (Cannabidiol), krebshemmende Eigenschaften besitzen. Es gibt Belege für eine Anzahl von Wirkmechanismen, darunter die Hemmung der Tumorzellproliferation, die Auslösung von Apoptosen und Autophagie, die Hemmung der Tumorinvasion und der Bildung von Metastasen, der Angioneogenese und der Chemoresistenz. Cannabinoide könnten auch vor einigen zytostatikabedingten Schäden schützen, darunter vor der Entwicklung einer peripheren Neuropathie. Allerdings wurden in einzelnen Untersuchungen auch krebsfördernde Eigenschaften von Cannabinoiden beobachtet. Die klinische Datenlage ist bisher sehr limitiert. Es gibt eindrucksvolle Fallberichte über eine erfolgreiche Krebstherapie mit CBD und THC sowie einige epidemiologische Studien und wenige klinische Daten, die ein therapeutisches Potenzial von cannabisbasierten Medikamenten unterstützen.

Abstract

Cannabis and cannabinoids can be helpful in palliating a number of cancer-associated symptoms, including loss of appetite with weight loss, nausea and vomiting, pain, sleep disturbances and depression. Some of these indications are now considered established. Basic research has also shown that a number of cannabinoids, including THC (dronabinol) and CBD (cannabidiol), have anti-cancer properties. There is evidence for a number of mechanisms, including inhibition of tumour cell proliferation, induction of apoptosis and autophagy, inhibition of tumour invasion and metastasis, angioneogenesis and chemoresistance. Cannabinoids may also protect against some cytostatic-related damage, including the development of peripheral neuropathy. However, cancer-promoting properties of cannabinoids have also been observed in some studies. The clinical data situation is very limited so far. There are impressive case reports of successful cancer therapy with CBD and THC as well as some epidemiological studies and few clinical data supporting a therapeutic potential of cannabis-based medicines.

Schlüsselwörter

Cannabis - Cannabinoide - THC - CBD - Marihuana - Krebs - Therapie

Key words

cannabis - cannabinoid - THC - CBD - marijuana - cancer - therapy


Publication History

Article published online:
08 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Bar-Lev Schleider L, Mechoulam R, Sikorin I. et al. Adherence, safety, and effectiveness of medical cannabis and epidemiological characteristics of the patient population: A prospective study. Front Med 2022; 9: 827849
    CrossrefPubMedGoogle Scholar
  • 2 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
    CrossrefPubMedGoogle Scholar
  • 3 Chan PC, Sills RC, Braun AG. et al. Toxicity and carcinogenicity of delta 9-tetrahydrocannabinol in Fischer rats and B6C3F1 mice. Fundam Appl Toxicol 1996; 30: 109-117
    CrossrefPubMedGoogle Scholar
  • 4 Clark TM. Scoping review and meta-analysis suggests that cannabis use may reduce cancer risk in the United States. Cannabis Cannabinoid Res 2021; 6: 413-434
    PubMedGoogle Scholar
  • 5 Desai R, Patel U, Goyal H. et al. In-hospital outcomes of inflammatory bowel disease in cannabis users: a nationwide propensity-matched analysis in the United States. Ann Transl Med 2019; 7: 252
    CrossrefPubMedGoogle Scholar
  • 6 ElTelbany A, Khoudari G, Al-Khadra Y. et al. Lower rates of hepatocellular carcinoma observed among cannabis users: A population-based study. Cureus 2022; 14: e24576
    PubMedGoogle Scholar
  • 7 Grotenhermen F. Cannabis bei Krebs: mehr Chancen als Risiken?. Dtsch Z Onkol 2018; 50: 188-192 DOI: 10.1055/a-0758-8908.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Grotenhermen F. Cannabis gegen Krebs: Der Stand der Wissenschaft und praktische Folgerungen für die Therapie. 2. Aufl. Solothurn, Schweiz: Nachtschatten Verlag; 2022
    Google Scholar
  • 9 Hashibe M, Morgenstern H, Cui Y. et al. Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case-control study. Cancer Epidemiol Biomarkers Prev 2006; 15: 1829-1834
    CrossrefPubMedGoogle Scholar
  • 10 Hinz B, Ramer R. Cannabinoids as anticancer drugs: current status of preclinical research. Br J Cancer 2022; 127: 1-13
    CrossrefPubMedGoogle Scholar
  • 11 Laborada J, Cohen PR. Cutaneous squamous cell carcinoma and lichen simplex chronicus successfully treated with topical cannabinoid oil: A case report and summary of cannabinoids in dermatology. Cureus 2022; 14: e23850
    PubMedGoogle Scholar
  • 12 Liew KL, Capuano E, Yung B. Lung cancer patient who had declined conventional cancer treatment: could the self-administration of ‘CBD oil’ be contributing to the observed tumour regression?. BMJ Case Rep 2021; 14: e244195
    CrossrefPubMedGoogle Scholar
  • 13 Likar R, Koestenberger M, Stultschnig M, Nahler G. Concomitant treatment of malignant brain tumours with CBD – A case series and review of the literature. Anticancer Res 2019; 39: 5797-5801
    CrossrefPubMedGoogle Scholar
  • 14 Lutz B. Das Endocannabinoiden-System. In: Müller-Vahl K, Grotenhermen F, Hrsg. Cannabis und Cannabinoide in der Medizin. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft; 2019: 61-74
    Google Scholar
  • 15 Müller-Vahl K, Grotenhermen F. Hrsg. Cannabis und Cannabinoide in der Medizin. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft; 2019
    Google Scholar
  • 16 Munson AE, Harris LS, Friedman MA. et al. Antineoplastic activity of cannabinoids. J Natl Cancer Inst 1975; 55: 597-602
    CrossrefPubMedGoogle Scholar
  • 17 Ramer R, Hinz B. Antitumorigenic targets of cannabinoids – current status and implications. Expert Opin Ther Targets 2016; 20: 1219-1235
    CrossrefPubMedGoogle Scholar
  • 18 Regelson W, Butler JR, Schulz J. et al. Tetrahydrocannbinol as an effective antidepressant and appetite-stimulating agent in advanced cancer patients. In: Braude MC, Szara S, eds. The pharmacology of marihuana. New York: Raven Press; 1976: 763-776
    Google Scholar
  • 19 Sallan SE, Zinberg NE, Frei E. Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N Engl J Med 1975; 293: 795-797
    CrossrefPubMedGoogle Scholar
  • 20 Sanchez C, Galve-Roperh I, Canova C. et al. Delta9-Tetrahydrocannabinol induces apoptosis in C6 glioma cells. FEBS Letters 1998; 436: 6-10
    CrossrefPubMedGoogle Scholar
  • 21 Singh Y, Bali C. Cannabis extract treatment for terminal acute lymphoblastic leukemia with a Philadelphia chromosome mutation. Case Rep Oncol 2013; 6: 585-592
    CrossrefPubMedGoogle Scholar
  • 22 Twelves C, Sabel M, Checketts D. et al. GWCA1208 study group. 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
    CrossrefPubMedGoogle Scholar
  • 23 Waissengrin B, Urban D, Leshem Y. Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience. J Pain Symptom Manage 2015; 49: 223-230
    CrossrefPubMedGoogle Scholar
  • 24 Glioblastoma Research Foundation. What is the average glioblastoma survival rate? Im Internet: https://gbmresearch.org/blog/glioblastoma-survival-rate; aufgerufen am 04.08.2022
    PubMed