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Evaluation of oromucosal nabiximols and vaporised botanical leaf cannabis in cancer-related anorexia cachexia syndrome in palliative care: A pharmacokinetic study and Phase III double-blind RCT

Project Member(s): Luckett, T., Phillips, J., Agar, M., Currow, D.

Funding or Partner Organisation: NSW Health Administration Corporation (NSW Health)

Start year: 2017

Summary: Background: Cannabis is reported to stimulate appetite and attributed to causing the 'munchies' in recreational users. Up to 80% of advanced cancer patients suffer debilitating loss of appetite, taste problems, and weight loss causing distress both to patients and families. Available appetite treatments (progestins/ corticosteroids) are limited and have unwanted side-effects and toxicity (such as blood clots, muscle weakness). Aims: This trial will evaluate two types of cannabis (Nabiximols (Sativex¿) and vaporized leaf cannabis) in people with Cancer-anorexia-cachexia-syndrome (CACS) despite best palliative and supportive care (e.g., exercise, nutrition), to see if cannabis can improve their appetite, ability to feel hungry and enjoyment of meals. We will also explore cannabis¿s impact on other distressing symptoms (fatigue, altered taste and smell for food, low mood, weight loss, nausea and insomnia) that often co-exist with poor appetite. Significance: CACS is an international palliative care research priority because of the great distress, morbidity and mortality it causes. Rigorous trials of oromucosal spray and cannabis leaf are cutting edge in palliative care, and will advance the science of medicinal cannabis as a basis for policy over and above the vicissitudes of current politicised debate. This research places NSW at the forefront of the evaluation of medicinal cannabis to ease suffering in cancer. This study will determine the effects of cannabinoids on other symptoms where medical cannabis has shown promise ¿ as it may impact on multiple symptoms that improve quality of life. Expected outcomes: If effective, cannabis will be a useful addition to the medications available in Australia for the treatment of advanced cancer symptoms.

FOR Codes: Cancer Therapy (excl. Chemotherapy and Radiation Therapy), Cancer and Related Disorders, Clinical health