A systematic review of 19 studies with 1,927 pediatric cancer patients found cannabinoids were most commonly used for chemotherapy-induced nausea and vomiting, with no serious cannabis-related adverse events reported.
Pediatric oncologists, palliative care specialists, medical cannabis researchers
1,927 pediatric cancer patients across 19 studies with no serious cannabis adverse events
What the researchers found
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.
Why it matters
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 numbers in context
34,611 citations screened; 19 studies included; 1,927 participants; 7 RCTs; 58% studied chemotherapy-induced nausea/vomiting; 0 serious cannabis-related adverse events
How the study worked
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.
What this study cannot tell us
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.
How to read the evidence
Comprehensive systematic review with registered protocol, but included studies were heterogeneous and mostly low quality.
When this study was published
Published 2023
The bigger picture
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.
Questions still open
- What are the optimal cannabinoid formulations and doses for pediatric cancer patients? How do cannabinoid side effects compare to standard antiemetics in children?
Common questions
Is cannabis safe for children with cancer?
What is cannabis most used for in pediatric cancer?
Read the original research
Cannabinoids for symptom management in children with cancer: A systematic review and meta-analysis.
Cancer, 129(22), 3656-3670
Citation
Chhabra, Manik; Ben-Eltriki, Mohamed; Paul, Arun; Lê, Mê-Linh; Herbert, Anthony; Oberoi, Sapna; Bradford, Natalie; Bowers, Alison; Rassekh, S Rod; Kelly, Lauren E. (2023). Cannabinoids for symptom management in children with cancer: A systematic review and meta-analysis.. Cancer, 129(22), 3656-3670. https://doi.org/10.1002/cncr.34920
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