Cannabis and Synthetic Cannabinoids in the Context of Cancer: A Review of Current Evidence and Future Directions

Cannabinoids are now being explored for their broader role in cancer treatment and not solely as agents for symptom relief. These compounds, which are derived from Cannabis sativa plants and synthetic analogs, are well known for their unique pharmacological profiles and therapeutic potentials by modulating the endocannabinoid system (ECS) and other significant cellular processes, including autophagy, apoptosis, and proliferation. This paper is unique among review articles in that it explores cannabinoids' anticancer potential from the perspectives of molecular mechanisms, clinical relevance, their supportive role in symptom relief, and their pharmacokinetics in cancer treatment. Significantly, cannabinoids have been observed to have dual effects on cancer progression, and they vary with the type of cancer, receptor expression, and microenvironmental factors, underscoring the complexity of their biological actions. Despite promising mechanistic data, most available evidence remains preclinical, with only limited randomized controlled trials assessing direct anticancer effects; moreover, the variations in cannabinoid formulations, dosing regimens, and receptor specificity make it difficult to compare the studies and limit the clinical relevance of the anticancer activities of cannabinoids. New strategies (such as nanocarrier drug delivery systems) show promise for improving cannabinoid-based anticancer activities. Future research should prioritize standardized experimental models, biomarker identification, and well-designed clinical trials to bridge the gap between mechanistic promise and validated clinical application.