Oral Cannabis for Taxane-Induced Neuropathy: A Pilot Randomized Placebo-Controlled Study

Area of Science:

• Oncology
• Neurology
• Pharmacology

Background:

• Taxane-induced peripheral neuropathy (TIPN) is a common and debilitating side effect of chemotherapy for breast cancer patients, with limited treatment options.
• Pre-clinical studies suggest that a combination of Δ⁹-tetrahydrocannabinol (THC) and cannabidiol (CBD) may synergistically alleviate TIPN symptoms.

Purpose of the Study:

• To assess the feasibility and tolerability of oral cannabis (100 mg CBD: 5 mg THC, TID) compared to placebo in patients experiencing painful TIPN.
• To conduct a preliminary evaluation of the efficacy of oral cannabis on pain, sleep, and neuropathy in TIPN patients.

Main Methods:

• An 8-week, double-blind, randomized pilot study involving 12 women with TIPN.
• Participants received either oral cannabis capsules (100 mg CBD: 5 mg THC, TID) or placebo.
• Daily online questionnaires tracked pain, sleep, and medication use; weekly questionnaires assessed neuropathy.

Main Results:

• The study was feasible and well-tolerated, with all participants completing the trial and requesting dose reductions in both groups.
• While overall measures of pain, pain interference, sleep, and functional well-being improved over time, cannabis significantly worsened neuropathy ratings.
• Cannabis also significantly worsened sleep and pain interference ratings compared to placebo.

Conclusions:

• Double-blind, placebo-controlled testing of oral cannabis for TIPN is feasible and well-tolerated in this patient population.
• Despite overall improvements in some symptoms, oral cannabis at this dose demonstrated worsening of neuropathy, sleep, and pain interference compared to placebo.
• These findings underscore the importance of placebo controls in cannabis research and suggest a need for further investigation with a range of doses for TIPN.