Dronabinol zur supportiven Therapie metastasierter maligner Melanome mit Lebermetastasen

Zutt et al. ·Der Hautarzt

Clear benefit GRADE Very low 24 citations

Samplen = 7 Pat.

Duration4 weeks evaluation period

EndpointAppetite and nausea

Blindingn.a.

DesignFallserie

Cannabinoidthc

Routeoral

Key finding

The majority of patients reported significant appetite increase and nausea decrease under dronabinol, although the effects decreased with disease progression.

Summary

Case series n=7 patients with metastasized malignant melanoma and liver metastases; dronabinol (Marinol) led to significant appetite increase and nausea reduction in the majority over several weeks. All patients reported mild to moderate dizziness, however without treatment discontinuation. Effects diminished with disease progression.

PopulationPatients with hematogenously metastasized malignant melanoma and liver metastases with loss of appetite and nausea, n=7

InterventionDronabinol (synthetic delta-9-THC, Marinol) orally as capsule

OutcomeMajority of patients reported significant increase in appetite and decrease in nausea over several weeks; all patients showed mild to moderate dizziness as side effect

Confidence in the evidence

Very low

The lowest GRADE level, the effect estimate remains uncertain.

Downgraded for

Imprecision

Quality profile

Sample size ★★★★★

Blinding —

Effect size Clear benefit

Citations / year ★★★★★

Authors

Zutt M, Hänßle H, Emmert S, Neumann C, Kretschmer L

DOI 10.1007/s00105-005-1063-x↗

Design: Fallserie

Abstract

Background: Loss of appetite and nausea can reduce the quality of life of patients with malignant melanoma and liver metastases. Often established antiemetic drugs fail to bring relief. Tetrahydrocannabinol (THC, Marinol), which is the active agent of Indian hemp, has been used successfully in this situation for other malignant tumors. Patients And Methods: We treated 7 patients with hematogenous metastatic melanoma and liver metastases suffering from extensive loss of appetite and nausea supportively with dronabinol (Marinol. All of these patients had previously received standard antiemetic therapy without adequate relief. Dronabinol is a synthetic Delta-tetrahydrocannabinol. The drug was administered in capsule form. We evaluated the palliative effects of dronabinol with a special patient evaluation form, which was filled out at the beginning of the therapy and again after 4 weeks. Results: The majority of patients described a significant increase in appetite and decrease in nausea. These effects remained for some weeks, but then decreased as metastases progressed and the general condition worsened. All of the patients experienced slight to moderate dizziness, but it was not sufficiently troubling to cause interruption or termination of therapy. Conclusion: Loss of appetite and nausea due to liver metastases of malignant melanoma can be treated in individual cases supportively with Dronabinol.

The impediment to action advances action. — Marcus Aurelius