药用大麻在晚期癌症中的肝酶作用:两项随机试验的副研究
Luke Scarborough1,2, Janet Hardy3,4, Taylan Gurgenci5
1Supportive and Palliative Care, Mater Health Services Brisbane, South Brisbane, Queensland, Australia lukescarborough@st-gemma.co.uk.
BMJ supportive & palliative care
|December 22, 2025
概括
药用大麻,包括大麻 (CBD) 和四大麻 (THC) /CBD配方,在晚期癌症患者中没有显著提高肝酶 (ALT/AST). 在使用研究剂量的前四周内,没有观察到肝脏不良影响.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 患有晚期恶性瘤的患者通常会出现需要息治疗的症状.
- 药用大麻正在研究癌症患者的症状管理.
- 大麻对肝功能的潜在影响,特别是氨酸转移酶 (ALT) 和酸胺转移酶 (AST) 水平,需要进行调查.
研究的目的:
- 为了确定药用大麻 (单独的cannabidiol与THC/CBD组合) 是否会在患有晚期癌症的患者中提高ALT或AST水平.
- 为了比较不同大麻配方对肝酶水平的影响.
- 评估医用大麻在该患者群体中肝功能方面的安全概况.
主要方法:
- 从两个多中心,随机,安慰剂对照试验 (MedCan1和MedCan2) 的数据分析.
- 包括287名患有晚期癌症的患者,接受CBD,THC/CBD或安慰剂的不断升级剂量.
- 在基线,第14天和第28天测量ALT和AST水平.
主要成果:
- 药用大麻在研究剂量 (高达600毫克CBD/天) 中没有引起ALT或AST升高.
- 只有CBD和THC/CBD配方之间没有观察到肝酶水平的临床显著差异.
- 在大麻组中,没有患者超过预定义的ALT/AST值 (3x或5xULN).
结论:
- 药用大麻产品在使用前四周内对晚期癌症患者的ALT或AST水平没有显著的不良影响.
- 研究的CBD和THC/CBD配方剂量在该人群中的肝酶水平方面似乎是安全的.
- 进一步的长期研究可能是有必要的,以确认持续的肝脏安全性.
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