Abstract B83: Cannabinoids as an adjuvant therapy for pancreatic cancer

Abstract

Abstract In over 20 states, cancer patients have access to cannabinoids (aka medical marijuana) to treat symptoms of chemotherapy, such as nausea and lack of appetite. However, new evidence, both scientific and empirical, suggests that higher doses of cannabinoids may be an effective adjuvant alongside traditional chemotherapy agents, such as Gemcitibine. While daily dosages of 10 to 40mg are commonly used to control nausea, pancreatic cancer cells are known to over express the endo-cannabinoid receptor CB1 one hundred fold, requiring much higher dosages. Cannabinoids target different receptors than traditional chemotherapy agents with low combinatorial toxicity, and as such present a class of new treatments. In an n=1 study of a patient with stage IV pancreatic adeno-carcinoma, we augmented the standard Gemcitibine chemotherapy with balanced initial doses of 50mg THC and 50mg CBD that increased over a four week period to achieve a 12.5 mg/kg total cannabinoid dosage. Curiously, after ten days the patient stopped presenting signs of cannabinoid use, such as red eyes, slurred speech and clumsiness. However, the patient’s CA-19-9 marker increased from 8,800 ul/L at diagnosis to 25,500. Over the next four weeks, dosage of CBD was held constant and THC was increased to 1050mg daily for a combined dosage of 20mg/kg. At week 6, the CA-19-9 marker began decreasing and cannabinoid dosage was leveled off, although a higher dosage was planned for weeks 8-12. At week 15, CA-19-9 markers dropped to pre-diagnosis levels and a CAT scanned revealed shrinkage of the tumor. Rate of decrease in CA-19-9 exceeded previously published rates for patients with positive outcomes from Gemcitibine alone. Although many pancreatic cancer patients have access to cannabinoids, issues such as potency, purity and bio-availablity will impact future adjuvant cannabinoid therapies. We have addressed these issues with existing technology in the hopes of supporting large scale trials that will examine the efficacy of Gemcitibine + cannabinoid adjuvants in the treatment of pancreatic cancer. Citation Format: Andy D. Hospodor. Cannabinoids as an adjuvant therapy for pancreatic cancer. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Innovations in Research and Treatment; May 18-21, 2014; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2015;75(13 Suppl):Abstract nr B83.