In a small pilot trial, 71% of cancer patients receiving a THC/CBD mouth spray achieved complete response for delayed chemotherapy nausea compared to 22% on placebo.
Read this if you are a cancer patient dealing with nausea that standard medications cannot fully control.
71% complete response with THC/CBD spray vs 22% with placebo for delayed chemo nausea
What the researchers found
Sixteen cancer patients with persistent nausea and vomiting despite standard anti-emetic treatment were randomized to a THC/CBD oral spray (7 patients) or placebo (9 patients) for the 120-hour post-chemotherapy period.
The cannabis-based medicine group showed a dramatically higher complete response rate: 71.4% (5 of 7) versus 22.2% (2 of 9) with placebo, a difference of 49.2 percentage points. The benefit was primarily in the delayed nausea period.
Only one patient in the cannabis group withdrew due to adverse events. While the overall incidence of adverse events was higher in the cannabis group (86% vs 67%), none were serious.
The mean daily dose was 4.8 sprays in both groups.
Why it matters
Delayed CINV remains a significant problem despite advances in anti-emetic therapy. This pilot trial suggested that a cannabis-based medicine could provide additional relief when standard treatments are insufficient.
The numbers in context
7 CBM patients, 9 placebo. Complete response: 71.4% vs 22.2% (difference 49.2%, 95% CI 1%-75%). Mean daily dose: 4.8 sprays. One withdrawal for adverse events. No serious adverse events.
How the study worked
Pilot, randomized, double-blind, placebo-controlled phase II clinical trial. Sixteen patients with chemotherapy-induced nausea and vomiting (CINV) refractory to standard anti-emetics were randomized to a whole-plant cannabis-based medicine (THC + CBD) or placebo as add-on therapy.
What this study cannot tell us
Very small sample (16 patients total). Pilot study not powered for definitive efficacy conclusions. The 95% confidence interval for the primary outcome was wide (1%-75%). Higher adverse event rate in the treatment group.
How to read the evidence
Very small pilot RCT (n=16). Promising results but needs confirmation in a larger phase III trial.
When this study was published
Published in 2010. Subsequent research has continued to explore cannabinoid-based anti-emetics as adjuncts to modern anti-emetic regimens.
The bigger picture
Cannabinoids have been used as anti-emetics since the 1980s (dronabinol, nabilone). This trial tested a newer delivery method (oral spray) with a combined THC/CBD formulation, showing promise for patients who do not respond to modern anti-emetic regimens.
Questions still open
- Would a larger phase III trial confirm these results? Is the combination of THC and CBD more effective than THC alone for CINV? What is the optimal dosing for anti-emetic effect?
Common questions
Why did this study focus on delayed nausea?
Is this the same as medical marijuana?
Read the original research
Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting.
British journal of clinical pharmacology, 70(5), 656-63
Citation
Duran, Marta; Pérez, Eulàlia; Abanades, Sergio; Vidal, Xavier; Saura, Cristina; Majem, Margarita; Arriola, Edurne; Rabanal, Manel; Pastor, Antoni; Farré, Magí; Rams, Neus; Laporte, Joan-Ramon; Capellà, Dolors. (2010). Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting.. British journal of clinical pharmacology, 70(5), 656-63. https://doi.org/10.1111/j.1365-2125.2010.03743.x
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