AUCTORES
Globalize your Research
Chat with us
Case Report | DOI: https://doi.org/10.31579/2642-973X/001
Old Brewery, Winchester Hants, U.K.
*Corresponding Author: Julian Kenyon, Old Brewery, Winchester Hants, U.K.E-mail: jnkenyon@doveclinic.com
Citation: Julian Kenyon, Report of Objective Clinical Responses in Patients with Brain Cancer to Pharmaceutical-Grade Synthetic Cannabidiol. Brain and Neurological Disorders. 1(1); DOI: 10.31579/2642-973X/001
Copyright: © Julian Kenyon. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 10 November 2018 | Accepted: 26 November 2018 | Published: 04 December 2018
Keywords: cannabiodial; glioma;brain cancer;cannabinoids.
Background/Aim: Cannabinoids are widely used in the management of pain, nausea and cachexia in cancer patients. However, there has been no objective clinical evidence of any anticancer activity yet. The aim of this study was to assess the effects of Pharmaceutical-Grade Synthetic Cannabidiol on a range of Brain Tumours
Patients and Methods: We analysed the data routinely collected as part of our treatment program in 11 Brain Cancer patients over a four- year period.
Results: Clinical responses were seen in all of these 11 patients, including a reduction in tumour size, as shown by repeat scans.
There were no side effects of any kind observed when using Pharmaceutical-Grade Synthetic Cannabidiol. Pharmaceutical-Grade Synthetic
Cannabidiol was supplied by STI Pharmaceuticals.
Conclusion: Pharmaceutical-Grade Synthetic Cannabidiol is a candidate for treating glioma patients.
The phytocannabinoids are a group of chemicals extracted from the cannabis plant. A number of them are able to impede cancer cell growth, induce apoptosis and autophagy, and inhibit angiogenesis. The most widely known phytocannabinoid is Δ9-tetrahydrocannabinol (THC), and although it possesses these anticancer effects, it is also psychoactive, which has arguably hampered its clinical development. It is thought that these actions are mediated in part by binding to cannabinoid receptors that are expressed on a number of tissue types (1). As one type of the receptor is found exclusively on brain cells, studies using THC have focused on this tissue type. In vitro data were promising and, in 2016, a pilot clinical study in patients with glioblastoma multiforme indicated THC was safe; however, no clear activity was reported (2). The dosages were possibly on the conservative side, to minimise psychoactivity that would naturally restrict the use of THC as drug. Of the 80+ phytocannabinoids, THC is possibly the only one to exhibit this psychoactivity. More recently, studies have diverted away from THC and focussed on other cannabinoids. The next most abundant compound is cannabidiol (CBD), which has a low affinity for the canonical cannabinoid receptors. In contrast to THC, in its pure state, according to the World Health Organisation, CBD did not have abuse potential and caused no harm (3). Studies have shown that in addition to being able to induce cell death directly, it is also capable of interfering with intracellular signalling (4). Alterations to pathways such as the PI3K/AKT/mTOR and the ERK, suggests that CBD can modify the way certain cancer cells react to other treatments. Indeed, studies have shown that combining CBD with conventional chemotherapy such as cytarabine and vincristine can lead to enhanced anticancer activity through modifications to these signalling pathways (5, 6). Furthermore, the sequence in which these drugs are administered can also influence overall activity (5). Studies have also indicated that in certain leukaemia cell lines, CBD can increase the expression of the cyclin- dependent kinase inhibitor p21waf1 (6). This increased level appears to be maintained by CBD, which inadvertently impedes cell death.
The findings of a number of studies designed to examine the role of cannabinoids in in the management of cancer symptoms varied. The most recent prospective analysis of nearly 3,000 patients using medical marijuana showed that a large proportion of patients reported improvement in their condition (8). Patients often feel conventional therapies are not working for them, and so they search the internet for alternative medicines. It is here that they find stories about cannabis working in patients with cancer, and understandably feel it is a route for them. The cannabis products they use vary, and can be in the form of whole plant extracts or purified oils; however, whatever the source, they self-prescribe dosages. A number of anecdotal positive responses have been reported, which sustains the interest in this type of medication.
In order to assess its potential use, we focused on giving patients with Brain Cancers of various sorts (DIPG, Anaplastic Ependymoma, Glioblastoma Multiforme) a Pharmaceutical- Grade Synthetic product at appropriate doses. Every patient in this study signed an informed consent allowing anonymous use of their data. Results with a whole range of solid tumours treated with Pharmaceutical-Grade Synthetic Cannabidiol has been previously reported (10).
Patients were given synthetic, Pharmaceutical-Grade Synthetic Cannabidiol (STI Pharmaceuticals), registered under the Pharmaceutical Specials scheme in oily drops at 5% (w/v) in 20 ml bottles. Each drop contained 1 mg of synthetic CBD in neutral oil. This was prescribed on an informed consent basis. 11 Brain Tumour patients decided to have this treatment (Table 1).
Table I. Tabular presentation of our results in 11 Brain Cancer patients.
Several of these patients had already been taking Cannabis Oil extracted from the Cannabis plant and bought on the Internet, with no beneficial response. This is currently illegal, as the Medicines and Health Regulatory Agency has defined CBD as a medicinal product, which can only be prescribed under the Pharmaceutical Specials scheme, as it is not currently a licensed medicinal product. Eight of these patients used Pharmaceutical-Grade Synthetic Cannabidiol as the only treatment(9).
CBD was administered on three days on and three days off basis, which clinically was found to be more effective than giving it as a continuous dose. The average dose was 10 mg twice a day. For increased tumour mass, the dose was increased, in some cases up to 30 drops twice a day (30 mg). In a number of cases where stable disease was present, the dose was reduced to five drops twice a day (5 mg). In some cases, Sativex, which is licensed for use in multiple sclerosis, was used in conjunction with CBD as a source of THC, which synergises with CBD (10). A fraction of the dose used for multiple sclerosis was used. Two sprays of Sativex were given twice a day in three days on and three days off pattern as in the case of Pharmaceutical-Grade Synthetic Cannabidiol; patients on continuous dosing did not do as well as
those on this on-off repeating regimen. Some of these patients reverted to cannabis oil bought on the Internet, and following this, the majority of these cases relapsed.
We were unable to define a maximum tolerated dose for CBD, as there was a complete absence of side effects. The minimum duration of treatment required for CBD was six months, but many continued for longer. Less than six months appeared inadequate and had little effect, and therefore cases in which CBD was used for less than six months have been defined as un-assessable, and not included in the current cohort of 11 cases.
We sought clear objective evidence of potential efficacy where no other treatment option was available. The most impressive case was a five-year old male patient with an anaplastic ependymoma, a very rare brain tumour. The patient had had all standard treatments, surgery on two occasions followed by chemotherapy and conformal photon radiotherapy. No further treatment options were available to him when treatment on CBD started in February 2016. A scan carried out in December 2016 showed that tumour volume had decreased by ~60%. Further scans, carried out since December 2016, continued to show stable disease. CBD was the only treatment. Four scans with the scan report at the top of each scan are appended (Figure 1A-D).
Figure 1
Study 06 01 2016 Further enlargement of the posterior fossa mass. There are some (particularly multimodal) features of radionecrosis but in the context of a previously rapidly progressive tumour then an element of disease progression should also be considered. A short term follow up scan would be informative. (a)
Study 13 04 2016. Conclusion: Further tumour progression and development of moderately severe supratentorial hydrocephalus (b)
30 09 16. Conclusion: Substantial improvement/reduction in size of the residual disease. There has been a substantial improvement in appearances with marked reduction in size of the posterior fossa tumour from 3.4 x 3.2cm in the saggital plane to 1.7 x 1.7cm (c)
Study done 14 12 2016.Consulsion: Continued Slow improvement. Clinical information: Impressive resolution of left CPA Recurrent Ependymoma repeat scan in two months. (d)
Another impressive case was a 50-year-old patient with progressive tanycytic ependymoma Grade 2 diagnosed in June 2013, treated with biopsy and radical radiotherapy, which was completed on 3rd June
2015. He refused chemotherapy, and had no further treatment options. He started on pharmaceutical-grade synthetic CBD in July 2016 at a dose of 10 drops twice a day, three days on and three days off (10 mg). Prior to this he had been taking, for some time, metformin, mebendazole, doxycycline and atorvastatin from an oncology clinic in Central London.
In January 2017 a repeat scan showed tumour reduction. At that point the patient stopped taking pharmaceutical-grade synthetic CBD and switched to cannabis oil extract obtained from an internet website. Further scans carried out in February 2018 showed doubling of tumour size and more growth down the brain stem. He has since restarted pharmaceutical-grade synthetic CBD and throughout continued to take the metformin, atorvastatin, doxycycline and mebendazole. So, the only change in November 2017 had been stopping the pharmaceutical- grade synthetic CBD and switching to cannabis oil extract obtained on the Internet (Figure 2A, B).
Figure 2—Scan report 1
There is a reduction in size and enhancement of the left periventricular tumour. There is almost complete resolution of the parenchymal enhancement with a couple of small ependymal nodules remaining, but slightly smaller. There is no significant change in the T2/FLAIR appearance with Wallarian de- generation extending into the corticospinal tracts. (a)
Figure 2 – Scan report 2
There is evidence of disease progression with a near doubling of the enhancing soft tissue arising from the ependymal surface of the left lateral ventricle and projecting into the body of the left lateral ventricle. There are new enhancing foci in the left putamen and subthalamic region with further non –enhancing T2 hyperintense tumour extending inferiorly into the left cerebral peduncle. (b)
From our laboratory studies, we would not expect any significant anti- cancer activity using continuous CBD alone, as we have only observed cancer cell line apoptosis (cell death) when the agent is washed out of culture and withdrawn. We have also observed a potential increased cell killing ability when given after chemotherapy.
Cannabinoids have an accepted useful role in the management of cancer symptoms, namely pain control, nausea and cachexia, but not as part of primary treatment. The fact that we have been able to document improvement in cancer in few patients strongly supports further studies of CBD-based products in cancer patients who have exhausted standard treatments. Our primary data in a murine glioma model (7) showing enhanced sensitivity to radiotherapy without any side effects, suggests this would be an ideal clinical trial to initiate in the first instance.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
