Central nervous system cancers and use of cannabis and related products: An updated narrative

Gliomas are a heterogenous group of central nervous system tumors with often devastating prognosis with difficult-to-manage symptoms. Options for newly diagnosed and recurrent gliomas are limited and include highly toxic chemotherapeutic agents, surgical resection, and radiation therapy. While the optimal therapeutic route for gliomas is unclear, outcomes are dismal regardless of the approach and novel treatment strategies are required urgently. Cannabinoids have been identified as potential adjuvant therapy to benefit glioma patients. Recent advances in legalization of cannabis and its derivatives have allowed researchers a window to study the role of these compounds not only in the preclinical setting but also the behaviors and adoption of cannabinoids from glioma patients. Despite promising preclinical data and early clinical efforts suggesting potential anticancer and palliative effects for cannabinoids in glioma, research investigating standardized, quality-assured medicinal cannabis is critical to inform clinicians and assist patient safety. In this chapter, we provide with an overview with the landscape on cannabinoids, their role in the context of gliomas while providing preclinical context, as well as potential clinical uses and our experience in observational studies.