Sequence of drug administration is crucial to the success of combination treatments for cancer using cannabinoids.
The sequential use of chemotherapy and cannabinoids more effectively kills cancer than chemotherapy alone, new findings suggest.
Cannabinoids are active chemicals in cannabis, that when extracted and purified, have demonstrated anticancer properties, particularly in certain brain cancers.
In a study published in the International Journal of Oncology, investigators sought to examine the effect of pairing cannabinoids and their anticancer activity in cell line models.
The investigators tested different combinations of cannabinoids against leukemia cells in the lab, to determine whether existing chemotherapy treatments worked successfully alongside the cannabinoids. They also sought to determine whether using the drugs in a different order had any impact.
The results of the study showed that the sequential use of an initial dose of chemotherapy first followed by cannabinoids significantly improved overall results against the cancer cells. Furthermore, several cannabinoids could be paired together to generate a superior effect to chemotherapy alone, according to the authors.
“The sequence of chemotherapy results in greater induction of apoptosis, which this was the opposite when the schedule of administration was reversed,” the authors wrote.
The findings suggest that a similar effect could be achieved with a lower dose of chemotherapy. If it could be translated to clinical use in humans, it would result in fewer and less severe chemotherapy-induced adverse events.
“We have shown for the first time that the order in which cannabinoids and chemotherapy are used is crucial in determining the overall effectiveness of this treatment,” said lead investigator Dr Wai Liu. “These extracts are highly concentrated and purified, so smoking marijuana will not have a similar effect. But cannabinoids are a very existing prospect in oncology, and studies such as ours serve to establish the best ways that they should be used to maximize a therapeutic effect.”
Other compounds may lessen adverse events resulting from chemotherapy in the G-quadruplex, which is considered an emerging therapeutic target in oncology because of its key role in DNA replication and translation.