Platinum-based chemotherapies such as oxaliplatin are used to treat gastrointestinal tumors, especially in the advanced setting. Although demonstrated to be an effective treatment, it is one of the most neurotoxic types of chemotherapy. It has been shown that more than 90% of oxaliplatin recipients experience acute neuropathy. This neuropathy, known as chemotherapy-induced peripheral neuropathy (CIPN), can be highly debilitating. Currently, interventions to treat or prevent this condition are limited. The role of cannabis in treating cancer-related pain and certain neuropathic conditions has been studied. However, clinical evidence on the effectiveness of cannabis for treating CIPN is lacking. In February 2021, the results of a retrospective analysis evaluating cannabis for this treatment purpose were published.
In this review, the medical records of 768 patients who had received chemotherapy regimens, including oxaliplatin, were reviewed. Patients were separated into those with no cannabis use, those who used cannabis before oxaliplatin, and those who used cannabis after oxaliplatin. Results demonstrated a protective effect of cannabis that was statistically significant and more robust in those patients who used cannabis before treatment with oxaliplatin. Although this study was retrospective in nature, strengths of this study include data reliability and length of the study period.
The mechanism through which cannabis impacts CIPN is not well understood; however, the results of an animal study published in November 2021 suggest that oxaliplatin-induced neuropathy is modified by cannabis through specific cannabinoid receptors such as CB1. As such, potential therapeutic targets involving the endocannabinoid system are being described. Prospective trials further investigating the use of cannabis in the prevention and treatment of CIPN in humans are on the horizon.