Cannabis for childhood cancer symptoms showed promise but rigorous dosing data is lacking

Of 19 studies (including 7 RCTs), cannabinoids were most commonly used for chemotherapy-induced nausea and vomiting (58%). Common side effects included somnolence, dizziness, dry mouth, and withdrawal from adverse events. No serious cannabis-related adverse events were reported across all included studies. However, evidence for optimal dosing, safety, and efficacy remained insufficient.

Systematic review registered with PROSPERO, searching MEDLINE, Embase, PsycINFO, and Cochrane Library. From 34,611 citations, 19 unique studies were included: 8 retrospective chart reviews, 7 RCTs, 2 open-label studies, and 2 case reports, totaling 1,927 pediatric cancer participants.

Despite growing interest in medical cannabis for pediatric cancer, this comprehensive review reveals a significant gap between clinical practice and evidence. The absence of serious adverse events is reassuring but insufficient to guide dosing.

The pediatric oncology community needs urgently designed, rigorous trials given that cannabinoids are already being used by families, often without standardized dosing or safety monitoring.

Included studies were heterogeneous in design, cannabinoid type, and outcome measures. Most studies had small samples and high risk of bias. The 7 RCTs were older studies using primarily nabilone or dronabinol.