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Delta-9-Tetrahydrocannabinol as an Antiemetic in Cancer Patients Receiving High-Dose Methotrexate
A Prospective, Randomized Evaluation
- ALFRED E. CHANG, M.D.;
- DAVID J. SHILING, M.D.;
- RICHARD C. STILLMAN, M.D.;
- NELSON H. GOLDBERG, M.D.;
- CLAUDIA A. SEIPP, R.N.;
- IVAN BAROFSKY, Ph.D.;
- RICHARD M. SIMON, Ph.D.; and
- STEVEN A. ROSENBERG, M.D., Ph.D.
Abstract
Fifteen patients with osteogenic sarcoma receiving high-dose methotrexate chemotherapy were studied in a randomized, double-blind, placebo-controlled trial of oral and smoked delta-9-tetrahydrocannabinol (THC) as an antiemetic. Each patient served as his or her own control. Fourteen of 15 patients had a reduction in nausea and vomiting on THC as compared to placebo. Delta-9-tetrahydrocannabinol was significantly more effective than placebo in reducing the number of vomiting and retching episodes, degree of nausea, duration of nausea, and volume of emesis (P < 0.001). There was a 72% incidence of nausea and vomiting on placebo. When plasma THC concentrations measured < 5.0 ng/mL, 5.0 to 10.0 ng/mL, and > 10.0 ng/mL, the incidences of nausea and vomiting were 44%, 21%, and 6%, respectively. Delta-9-tetrahydrocannabinol appears to have significant antiemetic properties when compared with placebo in patients receiving high-dose methotrexate.
Article and Author Information
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▸From the Surgery and Biometric Research Branches, Division of Cancer Treatment, National Cancer Institute; the Laboratory of Clinical Psychopharmacology and Unit on Geriatric Psychiatry, Division of Special Mental Health Research, National Institute of Mental Health; and the Division of Research, National Institute on Drug Abuse; National Institutes of Health; Bethesda, Maryland.
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▸Requests for reprints should be addressed to Alfred E. Chang, M.D.; Surgery Branch, National Cancer Institute, Building 10, Room 10N116; Bethesda, MD 20205.
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- Received May 4, 1979.
- Accepted August 29, 1979.
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