Evidence map›Paper›PMID 36240167›Full record

ArticlePloS one2022

Pilot clinical and pharmacokinetic study of Δ9-Tetrahydrocannabinol (THC)/Cannabidiol (CBD) nanoparticle oro-buccal spray in patients with advanced cancer experiencing uncontrolled pain.

Stephen Clarke, Belinda E Butcher, Andrew J McLachlan, Jeremy D Henson, David Rutolo, Sean Hall, Luis Vitetta

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Cannabinoids and opioid consumption in cancer pain: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  2. Pooled it
  3. Review
  4. Observational
  5. Adverse events associated with the use of cannabis-based products in people living with cancer: a systematic scoping review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Article
  6. Medicinal Cannabis and the Intestinal Microbiome.Pharmaceuticals (Basel, Switzerland) · 2024
    Review
  7. Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Stephen ClarkeRoyal North Shore Hospital, St Leonard's, New South Wales, Australia.ORCID 0000-0001-5817-1222
Belinda E ButcherWriteSource Medical Pty Ltd., Lane Cove, New South Wales, Australia.
Andrew J McLachlanSydney Pharmacy School, The University of Sydney, Camperdown, New South Wales, Australia.
Jeremy D HensonFaculty of Medicine, Prince of Wales Clinical School, University of New South Wales (UNSW), Sydney, New South Wales, Australia.
David RutoloMedlab Clinical, Alexandria, New South Wales, Australia.
Sean HallMedlab Clinical, Alexandria, New South Wales, Australia.ORCID 0000-0003-0090-7895
Luis VitettaFaculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.ORCID 0000-0002-7490-9298
The University of Sydney · AUUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This pilot study aimed to assess the safety, tolerability, pharmacokinetics and exploratory analgesic effect of a novel water-soluble oro-buccal nanoparticle spray of a cannabis-based medicine (MDCNS-01) in patients with advanced incurable malignancy with unrelieved pain from opioid analgesic. The study was a non-blinded single arm 2 stage study. Stage I was a single escalating dose (n = 5) [2.5 mg Δ9-THC and 2.5 mg CBD) versus a 3-fold escalated dose. Stage II was an up-titrated dose in patients with advanced cancers and intractable pain (n = 25). During Stage I with an increased cannabis-based medicine dose, maximum observed plasma concentrations of cannabinoids were dose dependant. The water-soluble formulation in the current study resulted in a higher median (min, max) systemic exposure of Δ9-THC than CBD (AUC from 2.5 mg each of Δ9-THC and CBD, was 1.71 ng mL.h-1 (1.1, 6.6) and 0.65 ng mL.h-1 (0.49, 4.1), respectively). During stage II a subgroup of patients diagnosed with breast and prostate cancers with bone metastases, had the highest mean pain score improvement from baseline of 40% (unadjusted) and 33% (adjusted for rescue medication use). For all patients the most reported adverse events were mild or moderate drowsiness affecting 11 (44%) and 4 (6%) patients, respectively, and nausea and vomiting that affected 18 (72%) patients. The water-soluble cannabis-based medicine provided acceptable bioavailability for Δ9-THC/CBD, appeared safe and tolerable in advanced incurable cancers with uncontrolled pain with preliminary evidence of analgesic efficacy.

Indexed as

CannabidiolCannabinoidsCannabisIntractable PainNanoparticlesNeoplasmsAnalgesicsAnalgesics, OpioidDronabinolHumansMalePilot ProjectsWaterAnalgesicsAnalgesics, OpioidCannabidiolCannabinoidsDronabinolWater

Identifiers

PMID36240167
PMCPMC9565400
OpenAlexW4306180737

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.