Cancer
Study register · detail Phase-2-RCT · Cancer · 2021

A Phase 2 Randomised Clinical Trial Assessing the Tolerability of Two Different Ratios of Medicinal Cannabis in Patients With High Grade Gliomas.

Clear benefit GRADE Moderate 60 citations
Samplen = 88 Pat.
Duration12 weeks
ControlRetrospective control group
EndpointFACT-Br
Blindingoffen
DesignPhase-2-RCT
Cannabinoidkombination
THC:CBD1:1
Key finding

The 1:1 ratio of medical cannabis significantly improved sleep, physical and functional capacity without serious adverse effects.

Summary

Phase 2 RCT n=88 patients with high-grade glioma; 1:1 THC:CBD ratio significantly improved physical capacity (p=0,025), functional wellbeing (p=0,014) and sleep (p=0,009) after 12 weeks; 11% disease reduction, 34% stable disease; no serious adverse events.

P
PopulationAdults with high-grade glioma (High-Grade Glioma), n=88, mean 53,3 years
I
InterventionMedical cannabis (THC-containing) in two different THC:CBD ratios (including 1:1), single nightly dose
C
ControlRetrospective control group (for secondary endpoints)
O
OutcomeFACT-Br: 1:1 ratio improved physical capacity (p=0,025), functional capacity (p=0,014) and sleep (p=0,009) from baseline to week 12; no serious adverse events
Confidence in the evidence
Moderate

The third of four GRADE levels, the effect estimate is probably reliable.

Downgraded for
Imprecision
Quality profile
Sample size
Blinding Open-label
Effect size Clear benefit
Citations / year
Authors
Schloss J, Lacey J, Sinclair J, Steel A, Sughrue M, Sibbritt D, Teo C.
DOI 10.3389/fonc.2021.649555
Design: Phase-2-RCT
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Abstract
<h4>Background</h4>Cannabis for cancer is very topical and, given the use of illicit cannabis preparations used in this vulnerable population, research investigating standardised, quality-assured medicinal cannabis is critical to inform clinicians and assist patient safety.<h4>Methods</h4>A randomized trial involving adult patients diagnosed with a high-grade glioma, no history of substance abuse, liver or kidney damage or myocardial infarction were eligible for inclusion in a tolerability study on two different ratios of medicinal cannabis. Baseline screening of brain morphology, blood pathology, functional status, and cognition was conducted. A retrospective control group was used for comparison for secondary outcomes.<h4>Results</h4>Participants (n=88) were on average 53.3 years old. A paired t-test assessed the Functional Assessment of Cancer Therapy for Brain Cancer (FACT-Br) between groups from baseline to week 12 found that the 1:1 ratio favoured both physical (p=0.025) and functional (p=0.014) capacity and improved sleep (p=0.009). Analysis of changes from baseline to week 12 also found 11% of 61 participants had a reduction in disease, 34% were stable, 16% had slight enhancement, and 10% had progressive disease. No serious adverse events occurred. Side effects included dry mouth, tiredness at night, dizziness, drowsiness.<h4>Conclusion</h4>This study demonstrated that a single nightly dose of THC-containing medicinal cannabis was safe, had no serious adverse effects and was well tolerated in patients. Medicinal cannabis significantly improved sleep, functional wellbeing, and quality of life.<h4>Clinical trial registration</h4>Australian New Zealand Clinical Trials Registry (ANZCTR) http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373556&isReview=true, identifier ACTRN12617001287325.

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