Evaluation of dronabinol to decrease opioid use for cancer-induced bone pain

Area of Science:

• Oncology
• Pain Management
• Pharmacology

Background:

• Breast cancer bone metastases (BM) cause significant cancer-induced bone pain (CIBP).
• Opioids are the primary treatment for CIBP but have side effects.
• Cannabinoid receptor agonists (CB2/CB1) show preclinical promise for reducing CIBP and bone degradation.

Purpose of the Study:

• To evaluate the efficacy of adding CB2/CB1 agonists to opioid therapy for CIBP in breast cancer patients.
• To determine if dronabinol can decrease opioid requirements in patients with BM.

Main Methods:

• A single-arm study involving 14 breast cancer patients with BM on opioid therapy.
• Patients received 10 mg dronabinol twice daily for 8 weeks.
• Primary endpoint was the proportion of patients decreasing opioid use by ≥20%.

Main Results:

• Four out of 14 evaluable patients met the primary endpoint, decreasing opioid use by ≥20%.
• Significant improvements were reported in pain severity, quality of life, and insomnia.
• A significant decrease in serum C-terminal telopeptide levels was observed.

Conclusions:

• Addition of dronabinol decreased opioid requirements for CIBP in this pilot study.
• Dronabinol improved patient-reported outcomes, including pain and quality of life.
• Further investigation into novel analgesics like dronabinol for CIBP is warranted.