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Inflammation as a Prognostic Biomarker to Evaluate the Effects of Medical Cannabis on Breast Cancer Patients’ Short- and Long-Term Outcomes

Alexandra McMahon
University of Miami

Co-Authors: Dr. Yan Wang1, Veronica Zhang2, Dr. Jennifer Hu2
1University of Florida 2University of Miami

Despite the increasingly prevalent use of medical cannabis (MC) in cancer patients as a treatment strategy for symptom management, few studies have examined the underlying biological mechanisms such as inflammation in predicting patient outcomes after MC use. The objective of this abstract was to bridge recent literature and our own data to illustrate how cannabis use may impact inflammation measured by C-reactive protein (CRP), which may subsequently predict treatment responses, quality of life (QOL), and clinical outcomes among cancer patients.

A review of literature was conducted to explore applications of C-reactive protein (CRP) as a potential prognostic biomarker in breast cancer patients initiating MC. PubMed and Medline databases were utilized with search terms ‘Cannabis’, ‘Marijuana’, C-Reactive Protein’, ‘Medical Cannabis, ‘Medical Marijuana’, and Breast Cancer’. We also capitalized on our laboratory’s pilot data from three NCI-funded projects (2010-2023) measuring high-sensitivity C-reactive protein (hsCRP) levels in pain, radiotherapy (RT)-induced skin toxicity and survival outcomes in breast cancer patients.

A review of the literature suggests that cannabis usage, specifically cannabinoid-2 receptor activation, promotes an anti-inflammatory response. There is growing evidence that inflammation/ inflammatory biomarkers, such as C-reactive protein (CRP), are affected by cannabinoid activation. Multiple studies reported alterations in CB1R and CB2R expression levels in breast cancer and previous small studies associated MC usage with lower CRP levels. All these findings suggest cannabis use may reduce inflammation measured by CRP. On the other hand, findings from our study found CRP to be significantly associated with patient outcomes including pain (p=0.002), radiotherapy-induced skin toxicities (p=0.028) and survival (p=0.005) in a multi-ethnic breast cancer population (n=63), suggesting CRP can be a prognostic biomarker for cancer patient outcomes.

Bridging the two pieces of evidence together, we hypothesize that CRP may have clinical significance as a prognostic biomarker in breast cancer patients initiating MC. Future research characterizing the longitudinal relationship between cannabis and C-reactive protein could provide insight into molecular mechanisms and effects on treatment responses, QOL and clinical outcomes in breast cancer patients initiating MC.

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