Table 2.
The ECS and cannabinoids during immunotherapy.
| Type of study | Cancer entity | ECS | ICIs | Outcome | Ref. |
|---|---|---|---|---|---|
| Experimental mouse model | Skin, colon, and lung cancers | AEA, CB2, THC | Anti-PD-1 | THC reduces the therapeutic effect | (43) |
| Experimental mouse model | NSCLC | CB2 | Anti-PD-1 | The absence of CB2 favors a positive response | (22) |
| Retrospective observational clinical study | Advanced melanoma, NSCLC, and renal clear cell carcinoma | Cannabis | Anti-PD-1 (nivolumab) | The consumption of cannabis reduced RR, without influencing PFS and OS | (44) |
| Prospective observational clinical study | Melanoma, NSCLC, renal cell carcinoma, and other types of cancer | Cannabis | Anti-PD-1 (nivolumab, pembrolizumab) anti-CTLA-4 (ipilimumab), anti-PD-L1 (durvalumab, atezolizumab) |
The consumption of cannabis before or during ICI immunotherapy associates with worsened clinical outcomes | (45) |
| Experimental mouse model and retrospective non-randomized study | Colorectal carcinoma (murine model, CT26 cell line), NSCLC (clinical study) | Cannabis | Anti-PD-1 (pembrolizumab) anti-PD-L1 |
No harmful effect of cannabis on the activity of pembrolizumab | (46) |
AEA, anandamide; CB2, cannabinoid receptor 2; CTLA-4, cytotoxic T-lymphocyte antigen-4; ICIs, immune checkpoint inhibitors; NSCLC, non-small cell lung cancer; OS, overall survival; PFS, progression-free survival, PD-1, programmed death-1; PD-L1, programmed death-ligand 1; RR, response rate; THC, tetrahydrocannabinol.