Psychedelic Science 2025: Clinical Perspectives on Psychedelics in Palliative Oncology

At the forefront of exploring psychedelic-assisted therapy in oncology and palliative care, Manish Agrawal, MD, returns as a featured speaker at Psychedelic Science Conference 2025 to share emerging research and clinical insights from his work with patients with cancer. An oncologist and co-founder and CEO of Sunstone Therapies, Agrawal has been instrumental in advancing the use of psilocybin to address the psychological and existential distress faced by patients with cancer.

In this interview with Pharmacy Times®, Agrawal discusses key themes from his upcoming presentation, including innovative therapeutic formats such as dyadic treatment, the challenges of measuring meaningful outcomes in psychedelic studies, and the growing receptivity within the oncology community. He also previews a collaborative workshop on psychedelic-assisted therapy in palliative care and reflects on the expanding dialogue surrounding psychedelics in serious illness.

Pharmacy Times: As a featured speaker at Psychedelic Science 2025, what topics will you be addressing, and what key messages do you hope to convey to attendees?

Manish Agrawal, MD: At psychedelic science, we’ll be talking about the use of psychedelics in patients with cancer. It's an exciting presentation at an exciting time, because more research has been ongoing with cancer patients, and I'll be highlighting some of our study designs.

So, one of our interests has been in alternative forms of delivery, beyond the traditional 2 therapists to 1 patient. We've been looking at group approaches for some time, but we've also begun a study, and more than halfway completed now, with treating a cancer patient and a family member with MDMA to see how the cancer has affected their relationship—and that's called a dyad study. So, that's 2 therapists and 2 patients, [and is] sort of a different therapeutic format. So, we'll be highlighting that.

Some of the other things we'll be highlighting is really some of the limitations of psychedelic studies in general, specifically around ability to measure what experiences patients are having. So, in our extensive experience now, what we're seeing is that some of the study end points don't fully capture all that is going on with a particular participant. For example, I gave a participant who was struggling with some isolation, and their depression scores improved somewhat on [Montgomery-Asberg Depression Rating Scale (MADRS)], but they made a comment that they downloaded a dating app and started to go out again and engage in other places socially, and that I found to be quite remarkable and not fully reflective on some of the traditional outcomes we've measured. So that's some of the highlights that we'll be talking about.

Pharmacy Times: At Psychedelic Science 2025, you're scheduled to co-lead a workshop on psychedelic-assisted therapy in palliative care alongside experts such as Anthony Bossis and Mary Cosimano. Could you share insights into the workshop's objectives?

Agrawal: I mean, the workshop is intended to help provide a broad overview for people that are new to psychedelics to therapy in this population, and so there'll be framing, bringing into context what has occurred, and also where this is going. I'll be talking a lot about our clinical research and what we've learned, the insights that we've gained—both what's known but also what's not known.

Then Mary Cosimano, LMSW, will be doing a lot of work, really specifically on the end of life, and even leading the group into an experiential process to really think about what end of life issues are. So, it's meant to sort of span this spectrum of historical context, research, and also what are these issues really getting at?

Psilocybe cubensis mushrooms growing on mycelium. Image Credit: © mindhive - stock.adobe.com

Pharmacy Times: In a prior interview with Pharmacy Times in April 2023, you discussed your publication in JAMA Oncology on psilocybin therapy for patients with cancer and major depression disorder. Since this publication, how has the oncology field responded?

Agrawal: It's been really positive. I would say, over time, people have asked about it. I've written editorials about it. So, it was novel, and now it's still novel, but it's not ‘I've never heard about it.’

So, I've been speaking to more oncology groups, and certainly the interest has increased, and the openness has increased to psychedelic-assisted therapy in general, because of the publications that have been coming out and increased public awareness, and that has trickled [down] to oncologists and the oncology world.