Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Purpose: To assess the safety, dosing, and preventive effects of cannabidiol (CBD) on chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving oxaliplatin- or paclitaxel-based chemotherapy. Methods: Patients with cancer scheduled to undergo treatment with carboplatin and paclitaxel (Carbo-Tax) or capecitabine and oxaliplatin (CAPOX) received 150 mg CBD oil twice daily (300 mg/daily) for 8 days beginning 1 day before initiation of chemotherapy. Ten CIPN-specific patient-reported outcome (PRO) measures were captured at baseline and each day after the first cycle of chemotherapy for 8 days. Multi-frequency vibrometry (MF-V) was captured at baseline and day 4 ± 1 after initiation of chemotherapy. Controls were obtained from a similar patient cohort that did not receive CBD. Adverse events were captured using the CTCAE ver. 4.03. Results: From March to December 2021, 54 patients were recruited. CBD-treated patients were significantly older (p = 0.013/0.037, CAPOX/Carbo-Tax) compared to controls. Patients receiving CBD and CAPOX or Carbo-Tax showed significantly lower (better) change in Z-scores in high-frequency MF-V (125 and 250 Hz) compared to controls. This difference was most pronounced for patients receiving Carbo-Tax (− 1.76, CI-95 = [− 2.52; − 1.02] at 250 Hz). CAPOX patients treated with CBD had significantly lower peak baseline-adjusted difference in three PRO items on cold sensitivity to touch, discomfort swallowing cold liquids, and throat discomfort (− 2.08, − 2.06, and − 1.81, CI-95 = [− 3.89; − 0.12], NRS 0–10). No significant differences in PRO items were found for patients receiving Carbo-Tax. Possible side effects included stomach pain (grades 1–2) for patients receiving CAPOX. Conclusion: CBD attenuated early symptoms of CIPN with no major safety concerns. Long-term follow-up is ongoing. Results should be confirmed in a larger, randomized study. Trial registration number: NCT 04,167,319 (U.S National Library of Medicine; ClinicalTrials.gov). Date of registration: November 18, 2019.

TidsskriftSupportive Care in Cancer
Sider (fra-til)9441–9451
Antal sider11
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
The authors would like to thank Glostrup Pharmacy and Nordic Cannabis Research for their support in partial funding of cannabidiol and the NEYE Foundation for funding the CINCAN-1 and -2 studies. In addition, we would like to thank the biostatisticians of OPEN, University of Southern Denmark, Inge Petersen, and Anna Mejldal for statistical consultation. Lastly, we would like to thank the patients for their time and for opening their homes to research visits.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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