Delta9-四氢大麻酚用于复发性多形性胶质母细胞瘤患者的一项临床试点研究。
A pilot clinical study of Delta9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme.
作者信息
Guzmán M, Duarte M J, Blázquez C, Ravina J, Rosa M C, Galve-Roperh I, Sánchez C, Velasco G, González-Feria L
机构信息
Department of Biochemistry and Molecular Biology I, School of Biology, Complutense University, Madrid 28040, Spain.
出版信息
Br J Cancer. 2006 Jul 17;95(2):197-203. doi: 10.1038/sj.bjc.6603236. Epub 2006 Jun 27.
Delta(9)-Tetrahydrocannabinol (THC) and other cannabinoids inhibit tumour growth and angiogenesis in animal models, so their potential application as antitumoral drugs has been suggested. However, the antitumoral effect of cannabinoids has never been tested in humans. Here we report the first clinical study aimed at assessing cannabinoid antitumoral action, specifically a pilot phase I trial in which nine patients with recurrent glioblastoma multiforme were administered THC intratumoraly. The patients had previously failed standard therapy (surgery and radiotherapy) and had clear evidence of tumour progression. The primary end point of the study was to determine the safety of intracranial THC administration. We also evaluated THC action on the length of survival and various tumour-cell parameters. A dose escalation regimen for THC administration was assessed. Cannabinoid delivery was safe and could be achieved without overt psychoactive effects. Median survival of the cohort from the beginning of cannabinoid administration was 24 weeks (95% confidence interval: 15-33). Delta(9)-Tetrahydrocannabinol inhibited tumour-cell proliferation in vitro and decreased tumour-cell Ki67 immunostaining when administered to two patients. The fair safety profile of THC, together with its possible antiproliferative action on tumour cells reported here and in other studies, may set the basis for future trials aimed at evaluating the potential antitumoral activity of cannabinoids.
Δ⁹-四氢大麻酚(THC)和其他大麻素在动物模型中可抑制肿瘤生长和血管生成,因此有人提出它们作为抗肿瘤药物的潜在应用价值。然而,大麻素的抗肿瘤作用从未在人体中进行过测试。在此,我们报告了第一项旨在评估大麻素抗肿瘤作用的临床研究,具体为一项I期试点试验,其中9例复发性多形性胶质母细胞瘤患者接受了肿瘤内注射THC。这些患者此前标准治疗(手术和放疗)失败,且有明确的肿瘤进展证据。该研究的主要终点是确定颅内注射THC的安全性。我们还评估了THC对生存时长和各种肿瘤细胞参数的作用。评估了THC给药的剂量递增方案。大麻素给药是安全的,且可在无明显精神活性作用的情况下实现。从开始给予大麻素起,该队列患者的中位生存期为24周(95%置信区间:15 - 33)。当给予两名患者THC时,其在体外抑制了肿瘤细胞增殖,并降低了肿瘤细胞Ki67免疫染色。THC良好的安全性,以及本文及其他研究中报道的其对肿瘤细胞可能的抗增殖作用,可能为未来旨在评估大麻素潜在抗肿瘤活性的试验奠定基础。