Cannabinoids in oncology: pharmacology, clinical applications, and translational perspectives.

Safran E.; Safran H.; Kim S. · Frontiers in pharmacology · 2026

**Background & Methods** This is a comprehensive review article (not an RCT as indicated in metadata) examining cannabinoid pharmacology and clinical applications in oncology. The review integrates evidence from preclinical studies, clinical trials, and observational data to assess cannabinoids' roles in cancer symptom management and potential antitumor activity. **Key Findings** • Strongest clinical evidence supports cannabinoids for refractory chemotherapy-induced nausea and vomiting (CINV), while evidence for cancer pain, appetite stimulation, sleep disturbance, anxiety, and opioid-sparing effects remains limited or inconsistent. • Preclinical studies demonstrate antiproliferative, proapoptotic, antiangiogenic, and immunomodulatory effects across multiple tumor models; however, cannabinoid signaling is context-dependent and may promote tumor progression in select settings. • No established human evidence demonstrates improved tumor response, progression-free survival, or overall survival with cannabinoid use; existing human data consist predominantly of small early-phase studies and observational data. **Dosage & Administration** Not reported. The review notes that THC and CBD differ substantially in receptor pharmacology, psychoactive effects, metabolism, and toxicity with important implications for product selection and dosing, but specific dosing regimens are not provided in the abstract. **Safety & Adverse Effects** Particular caution is warranted regarding neuropsychiatric and cardiovascular toxicity. Additional concerns include pharmacokinetic drug interactions with anticancer and supportive-care medications, and potential influence of cannabis on immune checkpoint inhibitor outcomes. **Evidence Quality** This is a narrative review article rather than a primary research study, limiting evidence hierarchy. The authors acknowledge that human evidence for direct anticancer activity is sparse and consists predominantly of small early-phase studies and observational data. Preclinical findings, while promising mechanistically, have not translated to demonstrated clinical benefit. The review identifies critical gaps including lack of standardized formulations, absence of rigorous randomized controlled trial designs in humans, and inconsistent endpoints. Future research priorities include standardized formulations, pharmacologically informed dosing, rigorous randomized designs, clinically meaningful endpoints, and biomarker-based approaches. Overall, cannabinoids demonstrate defined but limited roles in supportive oncology, while direct antitumor potential remains investigational.

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