Introduction
cancer, Inflammation, tumour, inflammation
CANCER, INFLAMMATION, ADVANCED CANCER, COMPLICATIONS, INFLAMMATION, TUMOUR, CHRONIC INFLAMMATION, TUMORIGENESIS
Inflammation plays an important role in tumour progression by either damaging resident tissues and facilitating tumorigenesis or fighting against cancer following an appropriate immune activation. Moreover, the positive association of chronic inflammation in the exacerbation of cancer is relevant to the discovery of new anti-cancer therapeutics. Consequently, the role of inflammation has been described as important in the aetiology, early detection, and prognosis of cancer [Specific symptom clusters have also been found to be associated with inflammation [A similar relationship has been proposed between quality of life and inflammation. A prospective observational study demonstrated a significant association between systemic inflammation and overall quality of life. When inflammation was stratified using the modified Glasgow Prognostic Score, the correlation was independent of performance status [Cannabidiol (CBD) is one of the major bioactive compounds in medicinal cannabis and is purported to have immunomodulatory properties. Unlike delta-9 tetrahydrocannabinol (THC), CBD is not psychoactive, which makes it desirable to many as a therapeutic option. Anecdotal data and some recent clinical evidence suggest that CBD may have a wide range of pharmacological properties including anxiolytic, antipsychotic, anti-oxidative, anticonvulsant, neuroprotective, and anti-inflammatory effects [Clinical trials are being undertaken to investigate the efficacy of CBD in patients with cancer and for the management of treatment-related complications. A recent Randomized controlled trial (RCT, MedCan-1) failed to show that CBD had any advantage over palliative care in managing symptoms related to advanced cancer [The present study sought to assess whether CBD would influence inflammatory markers in adults with advanced cancer in a randomised trial of CBD versus placebo. It was predicted that inflammatory marker expression would be significantly reduced in participants randomised to the CBD arm relative to the placebo arm. A positive result would justify a larger, adequately powered study of the anti-inflammatory effects of CBD in cancer patients.The overall objectives of this study were:To determine whether participants randomised to CBD oil had reduced CRP levels between baseline and day 14 and between baseline and day 28 compared to those on placebo, in patients participating in MedCan-1, a randomised controlled trial of CBD vs placebo [To determine whether CBD oil resulted in the reduction in levels of a panel of inflammatory markers, as measured in a subset of patients participating in MedCan-1.