CBD-oil as a potential solution in case of severe tamoxifen-related side effects.

Autor: Buijs SM; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. s.buijs@erasmusmc.nl., Braal CL; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Buck SAJ; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., van Maanen NF; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., van der Meijden-Erkelens LM; Clinical Cannabis Care Pharmacy, Breukelen, the Netherlands., Kuijper-Tissot van Patot HA; Clinical Cannabis Care Pharmacy, Breukelen, the Netherlands., Hoop EO; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Saes L; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., van den Boogerd SJ; Department of Medical Oncology, Alexander Monro Hospital, Bilthoven, The Netherlands., Struik LEM; Department of Internal Medicine, Ikazia Hospital, Rotterdam, The Netherlands., van Rossum-Schornagel QC; Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands., Mathijssen RHJ; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Koolen SLW; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands., Jager A; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: NPJ breast cancer [NPJ Breast Cancer] 2023 Aug 05; Vol. 9 (1), pp. 63. Date of Electronic Publication: 2023 Aug 05.
DOI: 10.1038/s41523-023-00570-x
Abstrakt: Tamoxifen may lead to bothersome side effects contributing to non-compliance and decreased quality of life. Patients searching for relief are increasingly turning to cannabinoids such as CBD-oil. However, CBD-oil might affect tamoxifen pharmacokinetics (PK) through CYP2D6 inhibition. The aims of this open-label, single-arm study were (1) to determine the PK profile of tamoxifen when using CBD-oil, and (2) to subsequently investigate whether CBD-oil has a beneficial influence on side effects. Study patients had to have steady-state endoxifen concentrations ≥16 nM (conservative threshold). PK sampling and side effect assessment was done at initiation of CBD-oil and 28 days thereafter. Bio-equivalence could be concluded if the 90% confidence interval (CI) for the difference in endoxifen AUC fell within the [-20%; +25%] interval. The effect of CBD-oil on side effects was evaluated using the FACT-ES questionnaire. Endoxifen AUC decreased after CBD-oil by 12.6% (n = 15, 90% CI -18.7%, -6.1%) but remained within bio-equivalence boundaries. The endocrine sub-scale of the FACT-ES improved clinically relevant with 6.7 points (n = 26, p < 0.001) and health-related quality of life improved with 4.7 points after using CBD (95% CI + 1.8, +7.6). We conclude that CBD-oil, if of good quality and with a dosage below 50 mg, does not have to be discouraged in patients using it for tamoxifen-related side effects. Clinical trial registration: International Clinical Trial Registry Platform (NL8786; https://www.who.int/clinical-trials-registry-platform ).
(© 2023. Springer Nature Limited.)
Databáze: MEDLINE
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