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Cannabinoids in the treatment of chemotherapy-induced nausea and vomiting.

Abstract

Before the introduction of the serotonin receptor antagonists (5-HT3 receptor antagonists) in the early 1990s, limited effective options were available to prevent and treat chemotherapy-induced nausea and vomiting (CINV). In 1985, the FDA approved 2 cannabinoid derivatives, dronabinol and nabilone, for the treatment of CINV not effectively treated by other agents. Today, the standard of care for prevention of CINV for highly and moderately emetogenic chemotherapy is a 5-HT3 receptor antagonist, dexamethasone, with or without aprepitant or fosaprepitant. With the approval of safer and more effective agents, cannabinoids are not recommended as first-line treatment for the prevention of CINV and are reserved for patients with breakthrough nausea and vomiting. Because of medical and legal concerns, the use of marijuana is not recommended for management of CINV and is not part of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Antiemesis. Although patients may like to pursue this treatment option in states that have approved the use of marijuana for medical purposes, its use remains legally and therapeutically controversial.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Roswell Park Cancer Institute, Buffalo, New York 14263, USA. barbara.todaro@roswellpark.org

    Source

    MeSH

    Antiemetics
    Antineoplastic Agents
    Cannabinoids
    Dronabinol
    Humans
    Nausea
    Vomiting

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22491047

    Citation

    Todaro, Barbara. "Cannabinoids in the Treatment of Chemotherapy-induced Nausea and Vomiting." Journal of the National Comprehensive Cancer Network : JNCCN, vol. 10, no. 4, 2012, pp. 487-92.
    Todaro B. Cannabinoids in the treatment of chemotherapy-induced nausea and vomiting. J Natl Compr Canc Netw. 2012;10(4):487-92.
    Todaro, B. (2012). Cannabinoids in the treatment of chemotherapy-induced nausea and vomiting. Journal of the National Comprehensive Cancer Network : JNCCN, 10(4), pp. 487-92.
    Todaro B. Cannabinoids in the Treatment of Chemotherapy-induced Nausea and Vomiting. J Natl Compr Canc Netw. 2012;10(4):487-92. PubMed PMID: 22491047.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cannabinoids in the treatment of chemotherapy-induced nausea and vomiting. A1 - Todaro,Barbara, PY - 2012/4/12/entrez PY - 2012/4/12/pubmed PY - 2012/8/8/medline SP - 487 EP - 92 JF - Journal of the National Comprehensive Cancer Network : JNCCN JO - J Natl Compr Canc Netw VL - 10 IS - 4 N2 - Before the introduction of the serotonin receptor antagonists (5-HT3 receptor antagonists) in the early 1990s, limited effective options were available to prevent and treat chemotherapy-induced nausea and vomiting (CINV). In 1985, the FDA approved 2 cannabinoid derivatives, dronabinol and nabilone, for the treatment of CINV not effectively treated by other agents. Today, the standard of care for prevention of CINV for highly and moderately emetogenic chemotherapy is a 5-HT3 receptor antagonist, dexamethasone, with or without aprepitant or fosaprepitant. With the approval of safer and more effective agents, cannabinoids are not recommended as first-line treatment for the prevention of CINV and are reserved for patients with breakthrough nausea and vomiting. Because of medical and legal concerns, the use of marijuana is not recommended for management of CINV and is not part of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Antiemesis. Although patients may like to pursue this treatment option in states that have approved the use of marijuana for medical purposes, its use remains legally and therapeutically controversial. SN - 1540-1413 UR - https://www.unboundmedicine.com/medline/citation/22491047/Cannabinoids_in_the_treatment_of_chemotherapy_induced_nausea_and_vomiting_ L2 - http://www.jnccn.org/cgi/pmidlookup?view=long&pmid=22491047 DB - PRIME DP - Unbound Medicine ER -