Table 3.

Anticancer effects of cannabinergic preparations in man

Disease, no. of patients	Drug	Results	Reference
Glioblastoma multiforme, grade IV, 15 patients	Pure CBD (mainly 400 mg/day PO) in addition to standard therapy (maximum resection of the tumour followed by radiochemotherapy)	Of 15 patients, 7 (46.7%) survived for at least 24 months, and 4 (26.7%) survived for at least 36 months. This is more than twice as long as has been previously reported in the literature. The mean overall survival is currently 24.2 months (median 21 months) and the 1-year survival rate was 87%	[77]
Glioblastoma multiforme , 9 patients (6 were grade IV)	Pure CBD (mainly 400 mg/day PO) in addition to standard therapy (maximum resection of the tumour followed by radiochemotherapy)	Of 9 patients, only 1 had died; mean survival time was 22.3 months (range 7–47 months)	[78]
Brain tumours, 2 patients	Pure CBD with <0.3% THC (case 1: glioblastoma multiforme: 300–450 mg/day; case 2: oligodendroglioma grade III: 100–200 mg/day following resection and chemoradiotherapy	Treatment reduced oedema and inflammation and induced remission (MRI)	[79]
Pilocytic astrocytoma, WHO grade 1; 2 females: case 1 was aged 11 years and case 2 was aged 13 years at diagnosis	Consumption of cannabis of unknown composition via inhalation, on average 3 × weekly during the last 3 years of follow-up	The volume of tumour remnant was calculated using VOXAR volumetric software, and was found to be 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 postoperatively in the second case; the regular use of cannabis coincided with the time course of radiological tumour regression	[126]
Glioblastoma multiforme, 12 patients with nabiximols, 9 with placebo	Nabiximols (CBD:THC ≃ 1:1, maximum 32.4 mg THC + 30.0 mg CBD) following standard chemoradiotherapy treatment with dose-intense TMZ, as described by Stupp et al. [88]	Median survival in the placebo group was >550 days in the CBD:THC treatment group (not significant) and 369 days in the placebo group; 1-year survival was 83% and 56% in the CBD:THC and placebo groups, respectively (p = 0.042)	[89]
Glioblastoma multiforme, 9 patients with progressive tumours	THC solution, 20–40 mg at Day 1, increased for 2–5 days up to 80–180 mg/day, infused into the resection cavity, starting at Days 3–6 after surgery; median duration of an administration cycle was 10 days	5 patients received more than 1 cycle. In 3 of these 5 patients, a temporary reduction of tumour proliferation was observed. Median survival of the cohort from the beginning of THC administration was 24 weeks	[87]
Pancreatic cancer, 9 patients with advanced, metastatic disease	Pure CBD, 400 mg daily, concomitant to standard chemotherapy (2 patients with CBD as the only treatment)	The mean overall survival of these 9 patients was 11.5 months (median 11 months) and seems to be longer than the overall survival reported in the literature for metastatic disease (5.9 months)	[80]
Ovarian carcinoma, metastatic, low grade, 81-year-old female	CBD oil of unknown composition; 1 drop sublingually each evening, concomitant to laetrile tablets, 500 mg PO 4 × daily started 2 months after surgery	The CA125 level was 77 at the time of surgery and 46 before starting CBD; 1 month later, CA125 normalized to 22	[82]
Lung adenocarcinoma (T1c N3 M0, biopsy-confirmed), 81-year-old male	CBD 2 × 1.32 mg/day (2% CBD oil) as the sole therapy, increased to 2 × 6 mg/day after 1 week	11 months after the diagnosis of lung cancer, the patient started CBD; the tumour was progressive at that time. The CT 4 months later revealed near total resolution of the left lower lobe mass and a significant reduction in size and number of mediastinal lymph nodes (stable according to a CT control 2 months later)	[83]
Lung cancer, terminal, 53-year-old male	Cannabis oil of unknown composition, daily inhalation with a vaporizer	After inhaling vaporized cannabis oil, the patient’s lung cancer (biopsy confirmed) disappeared within about 3 months; other symptoms also improved, however the patient died from cardiac failure about 1 year after the diagnostic interview	[84]
Lung cancer, non-metastatic, female in her 80s	0.5 mL cannabis oil (20% CBD, 19.5% THC, 24% THCA) PO 2–3 × daily	Progressive shrinking of the tumour from 41 mm at diagnosis to 10 mm 32 months later; no chemotherapy or radiation, no surgical intervention	[85]
Various cancers, 119 patients; most frequent were breast, prostate and colorectal cancer, as well as glioblastoma	CBD (synthetic) 10–30 mg 2 × daily (administered 3 days on, 3 days off) for ≥6 months (28 patients with CBD as the only treatment); in some cases, nabiximols was administered as conjunctive treatment (2 sprays 2 × daily, in parallel with CBD, equivalent to 10.8 mg THC + 10 mg CBD)	Clinical responses were seen in 92% of the 119 cases; patients receiving continuous dosing did not do as well as those receiving this on/off repeating regimen. Some patients reverted to using cannabis oil bought on the internet, and 80% of these cases subsequently relapsed	[76]
Squamous cell cancer of the right buccal cavity, 44-year-old male	0.5–1.0 g dried cannabis/day (8.21% CBD, 7.25% THC), vaporized every 2–4 h and 15 min before the patient’s daily wound dressing change; following resection and radiochemotherapy in the years before; when trismus and oral cutaneous fistula developed, the use of vaporized cannabis became technically difficult and was replaced by topical treatment (8.02% CBD, 5.24% THC)	The size of the malignant wound decreased by about 5% over the first 4-week interval; pain relief was so significant that the patient was able to discontinue pregabalin and dexamethasone while reducing hydromorphone to approximately 25% of his premedical cannabis dosage	[127]
Hodgkin lymphoma, stage IIB, 21-year-old pregnant female	History of Hodgkin lymphoma with incomplete remission after radiochemotherapy; 5 years later, the patient became pregnant; at 26 weeks of pregnancy, the patient began, on her own, a treatment with ‘cannabis oil’, supposed to be THC-predominant (1–5 mL 3 × daily, concomitant to opioids)	MRI scan revealed progression of disease; after starting cannabis, pain and general status improved and the tumour tissue decreased. The patient delivered a boy by C-section at 34 weeks who presented with withdrawal syndrome and intestinal invagination in the first 24 h postpartum, requiring care in the NICU and surgery with bowel resection	[128]
Acute lymphoblastic leukaemia, positive for Philadelphia chromosome mutation, 14-year-old female	Five different THC-rich extracts (‘Rick Simpson oil’) over a period of 78 days after unsuccessful bone marrow transplantation and chemotherapy	Extracts reduced blast cells but differed in their effects and adverse effects. With each new extract, the dose had to be adjusted again, starting with a lower dose; in parallel, blast cells increased. The appropriate dose was identified by the observation of adverse effects (euphoria, panic, appetite, nausea, fatigue) as guidance; the patient passed away due to the bowel perforation as a late effect of chemotherapy	[48]
Basal cell carcinoma, recurrent (nose), 74-year-old male	THC-rich extract (exact composition unknown), topical application 4 × daily for 2 weeks	After repeated surgical interventions, skin grafts and radiotherapy over the last 13 years, the malignant lesion completely disappeared within 2 weeks of daily treatment	[7]

CA125 cancer antigen 125, CBD cannabidiol, CT computed tomography, MRI magnetic resonance imaging, NICU neonatal intensive care unit, PO oral, THC tetrahydrocannabinol, THCA tetrahydrocannabinolic acid, TMZ temozolomide