Study register · detailMeta-Analyse · Cancer · 2025
Indications of Cannabinoids for the Palliation of Cancer-Associated Symptoms: A Systematic Review and Meta-Analysis.
Creanga-Murariu et al.·Current oncology reportsImpact 5.5
MixedGRADEHigh3 citations
Samplek = 98 Studien
Durationunclear
ControlStandard care, placebo or baseline values
EndpointPain intensity
Blindingunklar
DesignMeta-Analyse
”Key finding
Cannabinoids reduced pain and anxiety, showed trends toward improvement in appetite and nausea/vomiting, but had no effect on constipation, depression, fatigue, mobility or quality of life; THC-dominant formulations increased the risk of psychiatric, neurological and gastrointestinal adverse events.
Summary
Systematic review and meta-analysis on symptom control in cancer patients; k=98 studies (interventional + observational). Cannabinoids significantly reduced pain vs. baseline (MD=-1,22; 95% CI: -1,92; -0,52) and anxiety (MD=-1,30; 95% CI: -2,22; -0,39). Appetite, chemotherapy-induced nausea/vomiting (OR=2,18; 95% CI: 0,79; 6,00) and insomnia (MD=-1,08; 95% CI: -2,48; 0,33) showed a trend toward improvement. No effect on constipation, depression, fatigue, mobility or quality of life. THC-dominant formulations increased the risk of psychiatric (OR=10,62; 95% CI: 1,35; 83,57), neurological (OR=2,24; 95% CI: 1,15; 4,35) and gastrointestinal (OR=2,69; 95% CI: 0,73; 9,90) adverse events. PROSPERO CRD42023479375.
P
PopulationCancer patients with cancer-associated symptoms, pooled from 98 studies
I
InterventionCannabinoids (various formulations, including THC-predominant preparations)
C
ControlStandard care, placebo or baseline values
O
OutcomePain reduction (MRAW: -1,22; 95%-CI: -1,92; -0,52) and anxiety reduction (MRAW: -1,30; 95%-CI: -2,22; -0,39) vs. baseline; no significant effect on appetite, CINV, insomnia, depression, fatigue or quality of life; THC-predominant formulations increased the risk of psychiatric (OR: 10,62; CI: 1,35; 83,57), neurological (OR: 2,24; CI: 1,15; 4,35) and gastrointestinal (OR: 2,69; CI: 0,73; 9,90) adverse events
Confidence in the evidence
Very lowLowModerateHigh
High
The highest of four GRADE levels, the effect estimate is very reliable.
Quality profile
Sample size★★★★★
Blinding—
Effect sizeMixed
Citations / year★★★★★
Authors
Creanga-Murariu I, Rezus II, Karami R, Rancz A, Zolcsak A, Engh MA, Obeidat M, Tamba BI, Hegyi P, Bunduc S
Purpose Of The Review: As cancer survival rates are increasing, alternative treatments to improve quality of life, such as cannabinoids, are gaining attention. Although cannabinoids are widely used to manage cancer-related symptoms, clear guidelines are lacking. This systematic review and meta-analysis assessed the safety and efficacy of cannabinoids in the management of symptoms among cancer patients. The study protocol was registered on PROSPERO (CRD42023479375). A systematic search was conducted using three main databases (PubMed, Embase, and CENTRAL) on 4 November 2023. We included interventional and observational studies that evaluated cannabinoids for symptom management in cancer patients compared to standard care, placebo, or baseline values. Pooled mean differences (MD), proportions and odds ratios (OR), and the 95% confidence intervals (CI) were calculated with a random-effects model.
Recent Findings: Overall, 98 articles were eligible. Cannabinoids reduced pain (MRAW: -1.22, CI: -1.92; -0.52) and anxiety (MRAW: -1.30, CI: -2.22; -0.39) as compared to baseline values. Appetite (MRAW: -1.88, CI: -6.23; 2.46), chemotherapy-induced nausea and vomiting (OR: 2.18, CI: 0.79; 6.00), as well as insomnia (MD: -1.08, CI: -2.48; 0.33) presented with a tendency toward improvement. Cannabinoids do not influence constipation, depression, fatigue, mobility or overall quality of life. In terms of safety issues, THC-predominant formulations increase the risks of psychiatric (OR: 10.62, CI: 1.35; 83.57), neurological (OR:2.24, CI: 1.15; 4.35), and gastrointestinal (OR:2.69, CI:0.73;9.90) side effects. The risk of bias of articles included varied from some concerns to high. Cannabinoids may be beneficial for the treatment of cancer-related pain and anxiety; however, their use carries a significant risk of adverse effects, particularly psychiatric complications. Careful patient selection is essential when considering cannabinoid-based treatments.