Brain tumours treated with cannabinoids
| Disease | Treatment | Patient(s) | Results | Ref. |
|---|---|---|---|---|
Case 1: glioblastoma grade IV; Case 2: oligodendroglioma WHO grade III | Pure CBD with < 0.3% THC, following resection and radio-chemotherapy; Case 1, 300–450 mg per day; Case 2, 100–200 mg per day | 2 patients, 38 years old; both relapsing after TMZ | Treatment reduced oedema and inflammation and induced remission (MRI) | [54] |
| Pilocytic astrocytoma, WHO grade I | Consumption of inhaled cannabis of unknown composition, on average 3 times weekly during the last 3 years of follow-up | 2 girls; case 1 aged 11, case 2, 13 years at diagnose | Tumour volume was 1.28 cm3 at 9 months and 0.27 cm3 at 6 years post-surgery in the first case, and 3.3 cm3 at 18 months and 0.28 cm3 at 6 years post-operatively in the second case; the regular use of cannabis coincided with the time course of radiological tumour regression | [55] |
| Glioblastoma WHO grade IV | THC (100 mg/mL in ethanol) in 30 mL of physiological saline supplemented with human serum albumin, infused into the resection cavity on days 3 to 6 after surgery; dose increased from 20 mg on day 1 up to 180 mg on day 5 | 9 patients progressive after standard radio-chemotherapy; (median duration of a THC-cycle was 10 days) | In 3 of 5 patients who received more than one THC-cycle, a temporary reduction of tumour proliferation was observed; median survival of the cohort from the beginning of THC administration was 24 weeks | [56] |
| Glioblastoma WHO grade IV | Concomitant treatment with pure CBD, 200–600 mg/day, mainly CBD 400 mg/day (add-on to standard radio-chemotherapy) | 15 patients | CBD contributed to the long-term survival of glioblastoma patients (median 28 months, mean 30.9 months) effect depends on the dose | [57] |
| Diffuse midline gliomas | Average CBD dose ~5.4 mg/kg p.o. per day until patient passed away; CBD of unknown origin | 14 patients (mean 9.79 years, range 4–16 years) | Longer overall survival with CBD (mean 22.7 months); CBD seems to suppress ID-1 | [49] |
| High grade glioma | Cannabis extract with THC:CBD ratio of 1:1 or 4:1, single night daily dose over 12 weeks; 1:1 means THC 13.9 mg per day, CBD 9.8 mg per day; 4:1 means THC 22.2 mg per day, CBD 8.5 mg per day | 61 patients | Results favoured the 1:1 ratio of THC:CBD over 4:1 with 72% of patients demonstrating a reduction of the tumour mass or stable disease compared to 53.6% after 12 weeks; participants who had a reduction in disease received the 1:1 ratio; pure THC or pure CBD was not included; sleep, functional wellbeing, and quality of life improved | [58] |
| Glioblastoma grade IV | Nabiximols (CBD:THC ≃ 1:1), max. 32.4 mg THC + 30.0 mg CBD following standard radio-chemotherapy with dose-intense TMZ (after Stupp protocol) | 12 patients with nabiximols, 9 with placebo | Median survival was > 550 days with CBD:THC treatment (not signif.) and 369 days in the placebo group; 1 year survival was 83% and 44% in the CBD:THC and placebo groups, resp. (P = 0.042) | [59] |
| Anaplastic ependymoma WHO grade III, (diagnosed at the age of 1.5 years) | CBD 5 mg/day for 3 days on and then 3 days off in parallel with a ketogenic diet (start after two years of radio-chemotherapy and tumour recurrence); after relapse and further surgery/chemotherapy changed to daily dosing with a 5.6% CBD extract, 30 mg per day | 5-year-old boy, (twice surgery, radio-chemotherapy) | Reduction of the tumour by ~60% with CBD; stable disease ~7 years after diagnosis (latest update January 2021) | [22] |
MRI: magnetic resonance imaging; signif.: significant; p.o.: per os; resp.: respectively; ≃: almost equal; ~: about
