Glioblastoma Multiforme and Cannabinoid
Glioblastoma Multiforme (GBM) is fatal in both the adult and pediatric population. A diagnosis is devastating and patients are frequently turning to alternative therapies to increase both quality of life and life expectancy. In my own pediatric cannabis practice in Winnipeg, Manitoba, Canada every year I have a few patients who come to explore cannabinoids for this reason. After working with a few patients each year, both adults and pediatrics, I am excited to watch the research unfold regarding the role both Cannabidiol (CBD) and Tetrahydrocannabinol (THC) play in halting growth and increasing quality of life. Every patient I have had has experienced at least one of these and I’m excited to see what the future studies will show.
The current life expectancy is 12 – 15 mo after a diagnosis of GBM and the current treatments are chemotherapy and radiation. For many patients radiotherapy is used to shrink the tumor and add length to the patients life. Invasive tumor removing procedures are usually not available due to the complex nature of these tumors and their locations. Clinically when we use cannabinoids we are seeing patients live longer and with less symptoms than we would expect. In some patients we see relatively no growth or minimal growth of GBM on MRI for a period of time when we initiate high dose Cannabinoids but then after a while this effect seems to wane and the tumor grows again. Understanding this interaction between Cannabinoids and GBM cells is essential in utilizing the mechanism in future therapies.
CBD and GBM cells
With the increased quality and quantity of life, we have speculated that there is some protective effect that CBD is having and in some way it is interacting either directly or indirectly with GBM cells. Research currently is exploring the role of CBD in autophagy and inducing cell death. A recent paper in Scientific Reports published early 2020 by Ivanov, Graham et al published data supporting the hypothesis that CBD plays a role in GBM cell death. In this study they were able to show that CBD enhanced signalling pathways that increased GBM cell death in vitro and decreased cell preserving pathways thus altering the balance between death and survival. This is one of many studies in the recent years laying the groundwork for understanding the interactions between cannabinoids and cancer cells and helping us understand why we are seeing people clinically experiencing positive results.
Ivanov, V., Grabham, P., Wu, C., Hei, T. (2020). Inhibition of autophagic flux differently modulates cannabidiol-induced death in 2D and 3D glioblastoma cell cultures Scientific Reports 10(1), 2687. https://dx.doi.org/10.1038/s41598-020-59468-4