Can Cannabinoids have a Curative Impact on Glioblastoma?

Senators John McCain and Ted Kennedy, Beau Biden, son of former Vice-President Joe Biden, iconic lead singer of the Tragically Hip, Gordon Downey. Glioblastoma has had no shortage of notoriety through its well-known victims who have, through their sad journey, helped raise awareness of this deadly form of cancer. 

The diagnosis is devastating. The prognosis is even worse. The incidence of glioblastoma multiforme (GBM) is 2 to 3 in 100,000 people in the Canada, the US and Europe and it’s the most common type of primary malignant brain tumor with an average survival rate of less than a year, even with aggressive treatment. When it comes to addressing an unmet medical need, there would be no dispute that improving the outcome for individuals with GBM would be very high on the list.

Is it reasonable to believe that a cannabinoid could have a therapeutic benefit in managing or treating glioblastoma? While this disease leaves little room for cynicism or humor, one might quickly conclude “why not”. Cannabis is being poked and prodded for every likely health condition from skin care to nutrition to chemotherapy induced nausea and vomiting, acute cancer pain, chronic pain, mental illness and epilepsy. The list of possible therapeutic indications for cannabis is likely to grow to the extent of our imagination and the boundaries of scientific evidence.

A growing body of evidence suggests that cannabinoids have potent anti-tumor functions and could be used successfully in the treatment of Glioblastoma

As to whether any individual cannabinoid molecule or a blend of THC with CBD can play a curative role in the treatment for glioblastoma multiform, one needs to understand why up to now conventional treatment modalities have failed. Treatment of GBM has been elusive in part because of the Brain Blood Barrier (BBB) which often prevents therapies from reaching the targeted tumor cells. Novel delivery systems may one day be able to expedite the delivery of a wide range of drug molecules to the site of the tumor.

In late 2015, Researchers at Canada’s Sunnybrook Health Science Centre were able to penetrate the blood-brain barrier for the first time in history, effectively delivering medication directly to a patient’s brain tumour. Researchers are investigating ways they could use this technology to treat patients with glioblastoma. 

In an edition of The Onco’Zine Brief on PRX, recorded in March 2019, Peter Hofland, Ph.D talks with Guy Chamberland, M.Sc., Ph.D, about medicinal cannabis. Chamberland, is a Master Herbalist as well as Chief Executive Officer and Chief Scientific Officer of Tetra Bio-Pharma, a biopharmaceutical company developing cannabinoid-based drugs. Tetra Bio-Pharma has a clinical development program aimed at bringing novel drugs and treatments to patients and their healthcare providers.

Growing evidence suggests that cannabinoids have potent anti-tumor functions and could be used successfully in the treatment of GBM. [1] The therapeutic effect of cannabinoids is based on the reduction of tumor growth via inhibition of tumor proliferation and angiogenesis, but also via induction of tumor cell death. Experimental studies as early as the 1990’s demonstrated the preventive properties of THC in animal models of carcinogenicity.  These latter studies demonstrated that in a life-time exposure (2-years) of rodents to THC, survival of the treated rats was higher than that of placebo and the incidence of hormonal dependent tumors were reduced in a dose-related manner.  Additionally, cannabinoids were shown to inhibit the invasiveness and the stem cell-like properties of GBM tumors. There is much to learn but one thing for sure, cannabinoids, such as THC, are delivered to the brain tissue without the use of any tumor selective delivery technology.  That we know from its psychoactive properties.  We can only hope that a more selective mode of delivery to the brain will result in an enhanced efficacy in cancer patients.  At worse, the cannabinoid-based drugs will help improve quality of life in these patients.

According to another study, THC and CBD have a wide variety of biological effects by binding with and activating the type 1 and type 2 cannabinoid receptors (CB1 expressed in certain neuronal areas of the brain and CB2 expressed in the immune system and in glial cells). The activation of these receptors initiates a signalling pathway, called the endoplasmic reticulum stress response, which generates tumor cell autophagy by activating TRB3. [2]

Tetra Bio-Pharma’s drug development priorities are focused on oncology both in advanced cancer pain, chemotherapy-induced nausea and vomiting and on glioblastoma, an unmet medical need that has seen virtually no scientific advancement or substantive improvement in survival.

Reference

[1] Dumitru CA, Sandalcioglu IE, Karsak M. Cannabinoids in Glioblastoma Therapy: New Applications for Old Drugs. Front Mol Neurosci. 2018 May 16;11:159. doi: 10.3389/fnmol.2018.00159. eCollection 2018. [PubMed][Article]

[2] TN-TC11G (THC+CBD) Combination With Temozolomide and Radiotherapy in Patients With Newly-diagnosed Glioblastoma (GEINOCANN) – NCT03529448 [Clinical Trial


Last Editorial Review: March 31, 2019

Featured Image: Glioblastoma.  Courtesy:© 2010 – 2019. Tetra-Bio Pharma. Used with permission.

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