A Prospective Cohort Study of Patients with Non-Small Cell Lung Cancer and Multiple Myeloma to Assess the Benefits and Harms Related to Cannabis Use During Treatment

对非小细胞肺癌和多发性骨髓瘤患者进行的前瞻性队列研究，以评估治疗期间使用大麻的益处和危害

• 批准号: 10792363
• 负责人: Jennifer Cullen
• 金额: $ 62.21万
• 依托单位: BECKMAN RESEARCH INSTITUTE/CITY OF HOPE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10792363
• 关键词: Address; Adjuvant; African American; American; Anxiety; Attention; Autologous Stem Cell Transplantation; Belief; Black race; Bortezomib; Cancer Patient; Cannabis; Clinics and Hospitals; Cohort Studies; Common Terminology Criteria for Adverse Events; Communication; Communities; Complex Variables; Computer software; Counseling; Data; Data Collection; Dexamethasone; Disease-Free Survival; Dose; Education; Ensure; Ethnic Origin; Gatekeeping; Goals; Health Personnel; Hematologic Neoplasms; Herb; Immune checkpoint inhibitor; Immunotherapy; Impaired cognition; Knowledge; Latino; Legal; Malignant Neoplasms; Malignant neoplasm of lung; Medical; Medical Marijuana; Multiple Myeloma; National Health and Nutrition Examination Survey; Neoadjuvant Therapy; Newly Diagnosed; Nivolumab; Non-Small-Cell Lung Carcinoma; Oncologist; Oncology; Operative Surgical Procedures; PD-1 inhibitors; Participant; Patients; Pattern; Perception; Pharmaceutical Preparations; Phytotherapy; Platinum; Population; Positioning Attribute; Prevalence; Prospective Studies; Prospective, cohort study; Psychoses; Quality of life; Race; Recommendation; Reporting; Sampling; Schedule; Socioeconomic Factors; Solid Neoplasm; Standardization; Surveys; Symptoms; Therapeutic; Treatment Protocols; Washington; abuse liability; active method; cancer therapy; cancer type; cannabis use behavior; chemotherapy; cohort; compliance behavior; demographics; inflammatory marker; instrument; lenalidomide; marijuana use; marijuana user; patient population; side effect

With the majority of Americans supporting legalization of medical cannabis, the number of patients asking their clinicians about medical cannabis has also significantly increased. Many clinicians, however, feel that they have inadequate knowledge about the efficacy, side effects, and abuse potential of medical cannabis. One national survey of oncologists reported that only 30% felt sufficiently informed to make recommendations regarding medical cannabis use, even though 80% regularly conducted conversations about medical cannabis with patients. A study from Washington State found 21% of patients with cancer surveyed had used cannabis in the past month. Despite the common belief among many patients that herbal therapies such as cannabis are inherently safe, the evidence is growing that greater caution is needed with cannabis as it may have potential direct side effects and may lead to interactions between herbs such as cannabis and medications. Thus, an important knowledge gap exists regarding the use of cannabis by patients with cancer during active cancer treatment, and this prospective cohort study is proposed to address these questions. This study aims to assess the prevalence and patterns of cannabis use among patients with cancers of the lung and multiple myeloma during active treatment as well as inquire about the communication patterns regarding cannabis use with their treating medical team. In order to reduce the complex variables that exist between the types of cancers and treatments, we will study two unique cancer populations – non-small cell lung cancer (NSCLC) and multiple myeloma (MM), with each cohort studied separately. These patients provide a homogenous population of patients with cancer that have generally standardized treatment regimens. Cancer patients currently receive platinum-based chemotherapy either before (neoadjuvant) or after (adjuvant) receiving surgery together with a PD-1 inhibitor (a type of immune checkpoint inhibitor (ICI), ex. nivolumab). Newly diagnosed MM patients are recommended to receive induction therapy with lenalidomide, bortezomib, and dexamethasone (RVd) for three to six months followed by an autologous stem cell transplant (ASCT). These two cohorts provide unique opportunities to study the impact of cannabis use in both a solid tumor and hematologic cancer during chemotherapy. For the NSCLC cohort, we will also assess the effect of cannabis on immunotherapy efficacy. For the MM cohort, we will assess the effects of cannabis during ASCT. Concurrently, we will survey oncology healthcare providers about their perceptions, education, and practice patterns regarding cannabis use by patients. Data collection will include information about all the medications including prescription, over-the- counter, herbs, and supplements in order to assess for the prevalence of potential medication interactions with cannabis. We hypothesize that a substantial proportion of patients receiving cancer treatment are using cannabis (~20%) and that there are different patterns of cannabis related benefits and harms based on cancer type and treatment as well as patient demographics including socioeconomic factors.

由于大多数美国人支持医用大麻合法化，询问他们的患者数量