Cannabinoids for the prevention of chemotherapy-induced nausea and vomiting in oncological therapy: a systematic review.

PURPOSE

Cannabinoids are compounds that occur naturally in cannabis plants. The objective of this systematic review was to provide an overview of the existing evidence regarding the use of cannabinoids for the management of chemotherapy-induced nausea and vomiting (CINV) in cancer patients.

METHODS

A systematic literature search was conducted in June 2024 in five electronic databases (Embase, Cochrane, PsychInfo, CINAHL, and Medline) to identify studies examining the utilization, efficacy, and potential adverse effects of cannabinoid-based therapy in cancer patients.

RESULTS

A total of 32 studies comprising 1889 patients suffering from different cancer types were included in the systematic review. Cannabinoid-based therapy involved the oral administration of defined and approved cannabis preparations. Of the 22 studies comparing cannabinoid-based CINV management to now outdated antiemetic therapies, 12 found a significant benefit of cannabinoids in CINV management, and eight out of nine studies comparing cannabinoids to placebo observed such a benefit. Only one of the 32 studies with a risk of bias compared cannabinoids to guideline-based therapy with a 5-HT3 receptor antagonist, an NK1 receptor antagonist, and dexamethasone and demonstrated a benefit of cannabinoids in reducing nausea and vomiting, but the therapy was associated with cannabinoid-related side effects.

CONCLUSION

With only one study complying with modern antiemetic standards and considering the risks of side effects, clinical evidence to recommend cannabinoids for the management of CINV is deemed insufficient.

IMPLICATIONS FOR CANCER SURVIVORS

Cancer patients suffering from CINV might find alleviation using cannabinoids, but heterogenous results and side effects prevent clinical recommendation.