{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T09:45:24Z","timestamp":1787996724062,"version":"build-2784847793"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Australian Government Medical Research Future Fund","award":["APP1152232, APP2006191"],"award-info":[{"award-number":["APP1152232, APP2006191"]}]},{"name":"Australian Government Medical Research Future Fund","award":["APP1152232, APP2006191"],"award-info":[{"award-number":["APP1152232, APP2006191"]}]},{"name":"Australian Government Medical Research Future Fund","award":["APP1152232, APP2006191"],"award-info":[{"award-number":["APP1152232, APP2006191"]}]},{"name":"Mater Research Ltd"},{"DOI":"10.13039\/501100001794","name":"The University of Queensland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001794","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Patients  with  cancer commonly access cannabis hoping to relieve their symptoms. This study assessed whether a 1:1 10\u00a0mg\/ml THC:CBD combination oil could improve total symptom burden in patients with advanced cancer over that provided by palliative care alone.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Participants were randomised to medicinal cannabis (MC) or placebo oil; dose escalated over 14\u00a0days according to tolerance and efficacy and continued to day 28. Symptoms assessed using the Edmonton Symptom Assessment Scale (ESAS) were summated to give a total symptom distress score (TSDS). The primary outcome measure was the change from baseline in TSDS at day 14. Secondary outcomes included individual symptom scores, opioid use, participant-selected dose, QoL, psychological symptoms, global impression of change (GIC), and adverse effects.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The pre-planned sample size of 120 at day 14 was reached following the randomisation of 144 patients. Mean (SD) TSDS improved over time in both arms (\u2212\u20096.30 (12.3) MC,\u2009\u2212\u20096.98 (12.56) placebo, <jats:italic>p<\/jats:italic>\u2009=\u20090.76) to day 14 with no difference between arms. A statistically significant improvement in ESAS pain scores in the MC arm (mean (SD)\u2009\u2212\u20091.42 (2.15) MC and\u2009\u2212\u20090.46 (2.83) placebo, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) was at the expense of greater psychomimetic toxicity. Improvement in general well-being was greater for the placebo. GIC and the pain component of QoL both favoured MC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Patients can be informed that a 1:1 THC:CBD combination cannabis oil was no better than palliative care alone in palliating symptoms in patients with advanced cancer. A small benefit in pain control was associated with greater toxicity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>Australian New Zealand Clinical Trial Registry (ANZCTR): ACTRN12619000037101, 14\/01\/2019.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00520-025-09763-5","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T05:00:36Z","timestamp":1753333236000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Medicinal cannabis for symptom control in advanced cancer: a double-blind, placebo-controlled, randomised clinical trial of 1:1 tetrahydrocannabinol and cannabidiol"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1127-9951","authenticated-orcid":false,"given":"Janet R.","family":"Hardy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1574-4729","authenticated-orcid":false,"given":"Ristan M.","family":"Greer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0197-4504","authenticated-orcid":false,"given":"Anita M.","family":"Pelecanos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgie E.","family":"Huggett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3361-192X","authenticated-orcid":false,"given":"Alison M.","family":"Kearney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9695-9109","authenticated-orcid":false,"given":"Taylan H.","family":"Gurgenci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8198-0375","authenticated-orcid":false,"given":"Phillip D.","family":"Good","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"9763_CR1","doi-asserted-by":"publisher","first-page":"3498","DOI":"10.1002\/cncr.34922","volume":"129","author":"DR Azizoddin","year":"2023","unstructured":"Azizoddin DR, Cohn AM, Ulahannan SV et al (2023) Cannabis use among adults undergoing cancer treatment. 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Accessed Jan 2025"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-025-09763-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-025-09763-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-025-09763-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T05:00:38Z","timestamp":1753333238000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-025-09763-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":44,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["9763"],"URL":"https:\/\/doi.org\/10.1007\/s00520-025-09763-5","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,24]]},"assertion":[{"value":"12 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Mater Human Research Ethics Committee (HREC\/MML\/49348) on 14\/01\/2019.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"JH and PG are recipients of two Australian Government Future Fund grants (MRFF APP 1152232 and 2006191) designed to study the role (if any) of medicinal cannabis in the symptom control of patients receiving palliative care. RG was paid for statistical services from these grants as was the salary of GH. PG has also received a Queensland Health Clinical Research Fellowship grant to progress these studies. JH received payment for research sessions from Mater Research Ltd. Medicinal cannabis and placebo were supplied free of charge from Little Green Pharma Ltd (LGP). LGP had no role in the design, running, analysis or publication of trial results. TG, AP and AK declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"715"}}