Orexigenic Therapy With Delta-9-tetrahydrocannabinol in Advanced Cancer Patients With Chemosensory Abnormalities - a Pilot Study
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Purpose
To investigate delta-9-tetrahydrocannabinol's (THC) ability to increase food intake and improve food enjoyment for advanced cancer patients with taste and/or smell (chemosensory) abnormalities.
| Condition | Intervention | Phase |
|---|---|---|
|
Cancer Anorexia Taste Disorders Olfactory Disorders |
Drug: Marinol (Dronabinol) Other: Placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Double-blind, Randomized, Placebo Controlled Clinical Trial to Evaluate the Efficacy of Orexigenic Therapy With Delta-9-tetrahydrocannabinol in Advanced Cancer Patients With Chemosensory Abnormalities - a Pilot Study |
- Total caloric intake [ Time Frame: 22 days ]
- self-perceived chemosensory ability [ Time Frame: 22 days ]
- palatable food intake [ Time Frame: 22 days ]
- self-perceived appetite [ Time Frame: 22 days ]
- changes in nausea [ Time Frame: 22 days ]
- safety and tolerability [ Time Frame: 22 days ]
| Estimated Enrollment: | 80 |
| Study Start Date: | August 2006 |
| Study Completion Date: | November 2009 |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: 1 |
Drug: Marinol (Dronabinol)
Intervention description: Marinol (drug) is being used as an appetite stimulant for treatment of cancer-induced anorexia.
|
| Placebo Comparator: 2 |
Other: Placebo
N/A
|
Detailed Description:
Appetite stimulants are the common treatment for cancer-induced anorexia. However, only 30% of advanced cancer patients respond and benefit from appetite stimulants, which may be due in part to sensory abnormalities, as a person who is experiencing food aversion due to taste and smell changes may be unable to respond to these agents. Of the appetite stimulants available for use in clinical practice only Marinol, or THC, has the potential to increase food intake by improving appetite as well as by amplifying the taste of food through the brain's reward pathway.
A 22-day, double blind, randomized, placebo-controlled trial will be conducted. Participants will start at 2.5mg of THC or placebo once daily for the first 3 days and then increase to 2.5mg of THC or placebo twice daily before lunch and supper. Participant's will complete the following survey tools pre and post-treatment: Taste and Smell Survey to assess the severity and change in chemosensory complaint scores; 3-day dietary record to determine the change in caloric intake and shift in food preference by macronutrient analysis; 24-hour urine collections to validate the 3-day dietary record; Satiety Labelled Intensity Magnitude scale for subjective appetite ratings; Food Preference Checklist to assess objective shifts in macronutrient and flavor preferences; Functional Assessment of Anorexia/Cachexia Therapy questionnaire to assess participant's QOL; interview to determine the cause and effects of chemosensory alterations; Edmonton Symptom Assessment Scale to assess nausea; and Side Effect Survey to document the tolerability of the drug (post-treatment only). Participants will complete the survey tools with the aid of the researcher. All tools are short and easy to complete, which minimizes patient burden.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- advanced cancer patients (defined as locally recurrent or metastatic) over 18 years old with a decreased food intake for at least 2 weeks (reported by physician or subject)
- able to complete questionnaires in English
- able to provide informed consent
- life expectancy of greater than 2 months (as determined by physician)
- chemosensory complaint score > 1
Exclusion Criteria:
- receiving enteral or parenteral feedings
- allergies or sensitivity to THC and/or sesame seed oil
- history of substance abuse or psychotic episodes
- mechanical obstruction of alimentary tract, mouth or nose
- received chemotherapy in the last 2 weeks
- received radiation therapy to the head/neck area
- brain tumor
- nausea score greater than 5 on ESAS
- history of tachyarrhythmias, angina pectoris or hypertension
- current diagnosis of liver impairment
- use of marijuana within 30 days prior to start of trial
Contacts and Locations| Canada, Alberta | |
| Cross Cancer Institute | |
| Edmonton, Alberta, Canada, T6G 1Z2 | |
| Canada, Quebec | |
| Royal Victoria Hospital | |
| Montreal, Quebec, Canada, H2W 1S6 | |
| Principal Investigator: | Ingrid H. de Kock, MD | Alberta Health Services |
More Information
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| ClinicalTrials.gov Identifier: | NCT00316563 History of Changes |
| Other Study ID Numbers: | PS-8-0008 |
| Study First Received: | April 19, 2006 |
| Last Updated: | February 8, 2010 |
| Health Authority: | Canada: Health Canada |
Keywords provided by Alberta Health Services:
|
cannabinoids taste disorders olfaction disorders cancer palliative medicine caloric intake |
appetite reward tetrahydrocannabinol/therapeutic use anorexia/drug therapy quality of life chemosensory changes/drug therapy |
Additional relevant MeSH terms:
|
Congenital Abnormalities Anorexia Taste Disorders Signs and Symptoms, Digestive Signs and Symptoms Sensation Disorders Neurologic Manifestations Nervous System Diseases Tetrahydrocannabinol Hallucinogens |
Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Psychotropic Drugs Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents |
ClinicalTrials.gov processed this record on June 13, 2013