Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Cannabinoids, particularly dronabinol (synthetic THC) and nabilone, have scientific validation for use as adjunct therapies to manage chemotherapy-induced nausea and vomiting (CINV). Multiple randomized controlled trials and systematic reviews, including those cited by authoritative bodies such as the National Cancer Institute (NCI) and the American Society of Clinical Oncology (ASCO), support their efficacy, especially in patients who do not respond adequately to standard antiemetic regimens. Cannabinoids exert their effects by interacting with the endocannabinoid system, particularly CB1 receptors in the central nervous system, reducing both nausea and vomiting.

Both dronabinol and nabilone have been approved by the U.S. Food and Drug Administration (FDA) for CINV since the 1980s. Clinical guidelines recognize cannabinoids as a secondary option when first-line treatments (such as serotonin antagonists and NK1 antagonists) are ineffective. While meta-analyses confirm benefit over placebo, cannabinoids are generally not superior to modern antiemetics but can be helpful for refractory cases.

Cannabinoids also have demonstrated benefits for appetite stimulation in cancer patients experiencing anorexia. Common side effects include dizziness, dysphoria, and sedation, which may limit tolerability for some patients. Overall, the evidence base is robust for the specific indication of CINV, leading to their continued, though limited, clinical use in oncology supportive care.

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