Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Clinical trial design for cannabinoids in supportive cancer care: insights from a systematic review (126680)

Katrina Cao 1 2 , Amy Salter 3 , Olivia Bellas 1 2 , Courtney B Cross 1 2 , Caelleb Morcom 1 2 , Jessica Stanhope 3 , Hannah R Wardill 1 2
  1. School of Biomedicine, University of Adelaide, Adelaide, South Australia, Australia
  2. Supportive Oncology Research Group, Precision Cancer Medicine, South Australian Health and Medical Research Institute, Adelaide, South Austraila, Australia
  3. School of Public Health, University of Adelaide, Adelaide, South Australia, Australia

Cannabinoids have gained recent popularity for their potential to alleviate cancer treatment-related symptoms. However, current guidelines for cannabinoids in supportive oncology are limited due to heterogeneous trial designs and inconsistent evidence. This systematic review aims to address these challenges by a) comprehensively synthesising existing evidence on cannabinoids as a supportive oncology intervention and b) identifying key trial design features to inform future research.

Six databases were searched from inception to January 2023, updated in June 2025. Study screening, selection, and data extraction were conducted using Covidence software by two independent reviewers. Studies were included if they were primary research comparing the effects of cannabinoids on cancer treatment-related symptoms with a control or comparison group, in all people undergoing cancer therapy, regardless of type, stage, treatment status, or age. The quality of the evidence was assessed using the Cochrane risk of bias (RoB 2) tool. The systematic review protocol was registered on PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?ID = CRD42022373000. 

 A total of 87 studies involving 15,773 participants were included; 76 were assessed as ‘high risk’ of bias, and the remaining 11 had ‘some concerns.’  Across all cancer treatment-related symptoms, there were a greater number of studies indicating the benefits of cannabinoids. Regarding trial design, cannabinoids were most effective in studies that administered the intervention prophylactically, and in studies that allowed personalisation of dosing and product selection.

 This systematic review highlights the importance of pragmatic trial designs and offers strategies to support the translation of cannabinoid research findings into clinical practice. Trials should consider prescribing cannabinoids preventatively before symptom occurrence, accommodate personalised product selection and self-titrated dosing, and prioritise patient-reported outcome measures. Our findings also highlight the critical need for guidelines to standardise participant, intervention, comparator, and outcome selection and reporting to ensure that cannabinoid trials reflect the complexities of real-world supportive oncology settings.