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Concise review of the management of iatrogenic emesis using cannabinoids: emphasis on nabilone for chemotherapy-induced nausea and vomiting.

Abstract

Chemotherapy-induced nausea and vomiting (CINV) is a prevalent, distressing, and burdensome side effect of cancer chemotherapy. It is estimated to affect the majority of patients receiving certain anti-cancer drug regimens and can be treatment-limiting, even for life-saving medications. Despite seemingly numerous options, such as antimuscarinic anticholinergics, antihistamines, 5-HT3 receptor antagonists, dopamine receptor antagonists, and neurokinin-1 receptor antagonists, preventative therapies are often inadequately effective, particularly for "delayed CINV"-leaving an important unmet clinical need. Cannabinoid receptor agonists, by virtue of their unique mechanism of action and efficacy and safety data reported in clinical trials, appear to offer a useful additional option. The mechanistic value of cannabinoids has been well known for many years, but these agents may have been underutilized in the past because of the notoriety and legal status of marijuana. While botanical marijuana contains nearly 500 components, including the psychoactive tetrahydrocannabinol (THC), nabilone is an established, single-entity synthetic cannabinoid receptor agonist that has become the focus of renewed interest. We review the basic pharmacology and clinical trial data of nabilone for use in prophylaxis and treatment of CINV.

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  • Authors+Show Affiliations

    ,

    NEMA Research, Inc., 868 106th Ave North, Naples, FL, 34108, USA.

    ,

    NEMA Research, Inc., 868 106th Ave North, Naples, FL, 34108, USA.

    ,

    NEMA Research, Inc., 868 106th Ave North, Naples, FL, 34108, USA. joann@leqmedical.com.

    ,

    NEMA Research, Inc., 868 106th Ave North, Naples, FL, 34108, USA.

    University of Arizona College of Pharmacy, Tucson, AZ, USA.

    Source

    Cancer chemotherapy and pharmacology 79:3 2017 03 pg 467-477

    MeSH

    Antiemetics
    Antineoplastic Agents
    Cannabinoids
    Cannabis
    Dronabinol
    Humans
    Iatrogenic Disease
    Randomized Controlled Trials as Topic
    Vomiting

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    28235999

    Citation

    Pergolizzi, Joseph V., et al. "Concise Review of the Management of Iatrogenic Emesis Using Cannabinoids: Emphasis On Nabilone for Chemotherapy-induced Nausea and Vomiting." Cancer Chemotherapy and Pharmacology, vol. 79, no. 3, 2017, pp. 467-477.
    Pergolizzi JV, Taylor R, LeQuang JA, et al. Concise review of the management of iatrogenic emesis using cannabinoids: emphasis on nabilone for chemotherapy-induced nausea and vomiting. Cancer Chemother Pharmacol. 2017;79(3):467-477.
    Pergolizzi, J. V., Taylor, R., LeQuang, J. A., Zampogna, G., & Raffa, R. B. (2017). Concise review of the management of iatrogenic emesis using cannabinoids: emphasis on nabilone for chemotherapy-induced nausea and vomiting. Cancer Chemotherapy and Pharmacology, 79(3), pp. 467-477. doi:10.1007/s00280-017-3257-1.
    Pergolizzi JV, et al. Concise Review of the Management of Iatrogenic Emesis Using Cannabinoids: Emphasis On Nabilone for Chemotherapy-induced Nausea and Vomiting. Cancer Chemother Pharmacol. 2017;79(3):467-477. PubMed PMID: 28235999.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Concise review of the management of iatrogenic emesis using cannabinoids: emphasis on nabilone for chemotherapy-induced nausea and vomiting. AU - Pergolizzi,Joseph V,Jr AU - Taylor,Robert, AU - LeQuang,Jo Ann, AU - Zampogna,Gianpietro, AU - Raffa,Robert B, Y1 - 2017/02/24/ PY - 2017/01/27/received PY - 2017/02/06/accepted PY - 2017/2/27/pubmed PY - 2017/6/14/medline PY - 2017/2/26/entrez KW - CINV KW - Cannabinoids KW - Chemotherapy KW - Emesis KW - Nabilone SP - 467 EP - 477 JF - Cancer chemotherapy and pharmacology JO - Cancer Chemother. Pharmacol. VL - 79 IS - 3 N2 - Chemotherapy-induced nausea and vomiting (CINV) is a prevalent, distressing, and burdensome side effect of cancer chemotherapy. It is estimated to affect the majority of patients receiving certain anti-cancer drug regimens and can be treatment-limiting, even for life-saving medications. Despite seemingly numerous options, such as antimuscarinic anticholinergics, antihistamines, 5-HT3 receptor antagonists, dopamine receptor antagonists, and neurokinin-1 receptor antagonists, preventative therapies are often inadequately effective, particularly for "delayed CINV"-leaving an important unmet clinical need. Cannabinoid receptor agonists, by virtue of their unique mechanism of action and efficacy and safety data reported in clinical trials, appear to offer a useful additional option. The mechanistic value of cannabinoids has been well known for many years, but these agents may have been underutilized in the past because of the notoriety and legal status of marijuana. While botanical marijuana contains nearly 500 components, including the psychoactive tetrahydrocannabinol (THC), nabilone is an established, single-entity synthetic cannabinoid receptor agonist that has become the focus of renewed interest. We review the basic pharmacology and clinical trial data of nabilone for use in prophylaxis and treatment of CINV. SN - 1432-0843 UR - https://www.unboundmedicine.com/medline/citation/28235999/Concise_review_of_the_management_of_iatrogenic_emesis_using_cannabinoids:_emphasis_on_nabilone_for_chemotherapy_induced_nausea_and_vomiting_ L2 - https://dx.doi.org/10.1007/s00280-017-3257-1 DB - PRIME DP - Unbound Medicine ER -