A systematic review and meta-analysis examining the effects of cannabis and its derivatives in adults with malignant CNS tumors.

CNS tumors adult glioma cannabis clinical outcomes

Journal

Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528

Informations de publication

Date de publication:
Jul 2020
Historique:
entrez: 9 8 2020
pubmed: 9 8 2020
medline: 9 8 2020
Statut: ppublish

Résumé

Primary CNS tumors constitute a heterogeneous group of neoplasms that share a considerable morbidity and mortality rate. To help control tumor growth and clinical outcomes (overall survival, progression-free survival, quality of life) symptoms, patients often resort to alternative therapies, including the use of cannabis. Despite rapidly growing popularity, cannabis and its impact on patients with primary malignant CNS tumors is understudied. To shed light on the lack of scientific evidence in this field, in November 2018 we conducted a search and examination of cannabis in neuro-oncology in major journal databases and bibliographies of selected articles, and through abstracts of annual meetings using prespecified criteria in line with the Cochrane Collaboration guidelines. We identified 45 publications, of which 9 were selected. Five studies were included. Publication dates ranged from 2004 to 2018 and included varying histologies of primary brain tumors. The average survival at 1 year was 56.09% (95% CI: 48.28-63.9). There was no difference in risk ratio (RR) for death at 1 year between groups (RR: 1.069 [95% CI: 0.139-8.25]). We found strong evidence of heterogeneity (Q = 74.0%; There was limited moderate-quality evidence that supports the use of cannabinoids as adjuvant to the standard of care in the treatment of brain and CNS tumors. There was very low-quality evidence suggesting that cannabinoids were associated with adult-onset gliomas. Further prospective clinical trials are necessary to adequately evaluate the impact of cannabinoids on CNS tumors, specifically on survival and quality of life.

Sections du résumé

BACKGROUND BACKGROUND
Primary CNS tumors constitute a heterogeneous group of neoplasms that share a considerable morbidity and mortality rate. To help control tumor growth and clinical outcomes (overall survival, progression-free survival, quality of life) symptoms, patients often resort to alternative therapies, including the use of cannabis. Despite rapidly growing popularity, cannabis and its impact on patients with primary malignant CNS tumors is understudied.
METHODS METHODS
To shed light on the lack of scientific evidence in this field, in November 2018 we conducted a search and examination of cannabis in neuro-oncology in major journal databases and bibliographies of selected articles, and through abstracts of annual meetings using prespecified criteria in line with the Cochrane Collaboration guidelines.
RESULTS RESULTS
We identified 45 publications, of which 9 were selected. Five studies were included. Publication dates ranged from 2004 to 2018 and included varying histologies of primary brain tumors. The average survival at 1 year was 56.09% (95% CI: 48.28-63.9). There was no difference in risk ratio (RR) for death at 1 year between groups (RR: 1.069 [95% CI: 0.139-8.25]). We found strong evidence of heterogeneity (Q = 74.0%;
CONCLUSIONS CONCLUSIONS
There was limited moderate-quality evidence that supports the use of cannabinoids as adjuvant to the standard of care in the treatment of brain and CNS tumors. There was very low-quality evidence suggesting that cannabinoids were associated with adult-onset gliomas. Further prospective clinical trials are necessary to adequately evaluate the impact of cannabinoids on CNS tumors, specifically on survival and quality of life.

Identifiants

pubmed: 32765889
doi: 10.1093/nop/npaa013
pii: npaa013
pmc: PMC7393278
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

376-383

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Auteurs

Jesus-Eduardo Rodriguez-Almaraz (JE)

University of California, San Francisco, Neuro-Oncology Division.

Susan Chang (S)

University of California, San Francisco, Neuro-Oncology Division.

Jennifer Clarke (J)

University of California, San Francisco, Neuro-Oncology Division.

Nancy Ann Oberheim-Bush (NA)

University of California, San Francisco, Neuro-Oncology Division.

Jennie Taylor (J)

University of California, San Francisco, Neuro-Oncology Division.

Robin Buerki (R)

University of California, San Francisco, Neuro-Oncology Division.

Mitchel Berger (M)

University of California, San Francisco, Neuro-Oncology Division.

Lydia Zablotska (L)

University of California, San Francisco, Department of Epidemiology and Biostatistics.

Iryna Lobach (I)

University of California, San Francisco, Department of Epidemiology and Biostatistics.

Nicholas Butowski (N)

University of California, San Francisco, Neuro-Oncology Division.

Classifications MeSH