2073P - Medical cannabis: A potential effective treatment for chemotherapy-induced peripheral neuropathy (CIPN)

Background

Medical cannabis is extensively used by Israeli cancer patients, mostly in the form of natural extracts. We've previously shown that cannabis can alleviate symptoms of Oxaliplatin induced CIPN. Yet, it is still unknown which cannabis component, either tetrahydrocannabinol (THC) or cannabidiol (CBD) contribute to this effect and at which dose.

Methods

A database of 5,063 medical records consecutive patients of medical cannabis clinic ('Tikun Olam') was reviewed. 802 patients reported CIPN related symptoms and 751 met inclusion criteria were included in the analysis. Data included questionnaires regarding Patient Reported Outcome (PROM), Activities of Daily Living (ADL) and Quality of Life (QOL) filled before and six months after cannabis use. Four CIPN symptoms were observed. Improvement was defined as positive change from baseline score. Two patients' clusters were identified using k-mean clustering method to study the association between THC, CBD and change in symptoms, ADL and QOL: CBDhigh/ THClow and THChigh/ CBDlow doses.

Results

Symptoms frequency before cannabis use: paresthesia (549pts, 73%), burning sensation (358pts, 48%), numbness (235pts, 31%) and cold sensation (146pts, 19%). After cannabis use improvement reported in paresthesia (320pts, 58%), burning sensation (217pts, 60%), numbness (112pts, 47%) and cold sensation (67pts, 45%). Burning and cold sensation improvement was 37% and 15% in THChigh compare to 27% and 8% in CBDhigh cluster (p=0.02 and p=0.008, respectively). ADL and QOL change were higher in THChigh cluster (p=0.03 and p=0.006, respectively).

Conclusions

The use of natural extracts of cannabis can effectively alleviate CIPN symptoms and improve both QOL and ADL with suggested advantage to high THC levels. Further analysis is required to better correlate specific symptoms to specific components.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Institutional Review Board - Tel Aviv Medical Center.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.