While cannabis remains illegal on the federal level in the United States, federal health agencies have shown more support for cannabis research in recent years. As more states legalize both medical and recreational cannabis use, funding opportunities from agencies under the National Institute of Health have invited research in areas such as pain management and driver safety. Most recently, the National Cancer Institute has issued a Notice of Special Interest promoting funding opportunities for research into the potential role of cannabis in cancer biology and treatment.
The Notice of Special Interest, published May 5, 2022, notes that a recent survey suggests as many as one in four cancer patients have used cannabis to manage their symptoms. However, research into the health effects of cannabis, and the potential harms or benefits in relation to cancer, remain limited or inconsistent, according to the notice. For example, while cannabis smoke generates similar carcinogens as tobacco, no studies to date have shown a link between cannabis smoking and lung cancer risk; additionally, studies of cannabinoid effects in cancer cells lines and animal models have shown both tumor promoting and tumor suppressive properties. The notice states that more research examining the mechanisms by which cannabis and its constituents affect cancer biology, interception, treatment and symptoms is needed as cannabis and cannabinoid use among both cancer patients and the general public increases.
The notice outlines areas of research interest including, but not limited to:
- Understanding how exogenous cannabis and cannabinoids affect cancer development (preneoplasia through malignancy) and biology, including the tumor microenvironment;
- Understanding how endogenous cannabinoid pathways influence cancer development and biology;
- Defining the effects of cannabis and cannabinoids on cancer treatment (particularly targeted treatments and immunotherapy) and the development of treatment resistance;
- Understanding the use of cannabis and cannabinoids in cancer interception and delineating how endocannabinoid signaling pathways may inhibit early cancers;
- Defining the mechanisms of cannabis and cannabinoid action in alleviating symptoms of cancer and cancer treatment (such as pain, nausea and neuropathy);
- Understanding the combinatorial effects of cannabis and cannabinoids in conjunction with other factors (such as tobacco constituents, alcohol, microbiome or diet) on cancer biology, treatment and symptom management;
- Identifying biological mechanisms underlying disparities in sex or ethnicity in cannabis and cannabinoid action in cancer biology, treatment or symptom management; and
- Developing or validating new and human-relevant model systems to understand cannabis and cannabinoid action in cancer biology, treatment or symptom management.
Sixteen NIH grants with application deadlines on or after June 5, 2022 are included in the notice, with studies integrating expertise from multiple disciplines, incorporating state-of-the-art, human-relevant models (e.g. organoid or patient-derived xenograft models) and utilizing advanced technologies and methods being “strongly encouraged.” Relevant forms of cannabinoids for study include exogenous cannabis, cannabis-derived products or extracts, purified or synthetic cannabinoids and endogenous cannabinoids. Applications for clinical trials, research on symptoms not related to cancer or cancer treatment, and products that lack cancer models, specimens or cells, will not be accepted.