What the Evidence Actually Shows About CBD and Neuroblastoma
Laboratory research has raised a possible lead for future neuroblastoma treatments, but it has not shown that cannabis or cannabidiol (CBD) can cure the disease in children.
Neuroblastoma is a cancer of immature nerve cells that most often develops in young children. It commonly begins in the adrenal glands but can also occur in the neck, chest, abdomen, or spine. Treatment depends on the tumor’s risk category and may include surgery, chemotherapy, radiation, stem-cell rescue, targeted therapy, immunotherapy, or participation in a clinical trial, according to the National Cancer Institute’s neuroblastoma overview.
The research that prompted interest in CBD was a 2016 preclinical study, “In vitro and in vivo efficacy of non-psychoactive cannabidiol in neuroblastoma”, published in Current Oncology. Researchers tested CBD and tetrahydrocannabinol (THC) against several human neuroblastoma cell lines in the laboratory. They also implanted one of the cell lines into immunodeficient mice to create tumor xenografts.
Both cannabinoids reduced the viability of neuroblastoma cells in culture, while CBD generally produced the stronger effect. The researchers also observed reduced invasiveness and signs of apoptosis, a form of programmed cell death. In mice, CBD and THC slowed the growth of the implanted tumors, with CBD again showing greater activity in the experiments described.
Those findings are scientifically important, but they remain preclinical. The study was conducted in cell cultures and mice—not in children with neuroblastoma. Results at those stages cannot establish the appropriate human dose, long-term safety, effectiveness against different forms of the disease, or whether CBD would improve survival. The study also did not test CBD alongside the full combination of treatments commonly used for high-risk neuroblastoma.
Cannabis-derived medicines may have a role in managing some cancer-treatment symptoms, particularly chemotherapy-related nausea and vomiting. However, the evidence varies by product and symptom. In the United States, the FDA has approved the cannabinoid medicines dronabinol and nabilone for chemotherapy-related nausea and vomiting when standard treatments have not worked adequately. It has not approved cannabis or CBD as a treatment for cancer, and purified CBD is approved for certain seizure disorders—not neuroblastoma. The FDA summarizes these distinctions in its cannabis and drug-approval guidance.
The National Cancer Institute likewise describes cannabinoids primarily as potential tools for symptom management and as subjects of laboratory and early clinical research. Its cancer information on cannabis and cannabinoids notes that concentrated CBD products may interact with medications, including some cancer therapies, by affecting drug-metabolizing enzymes. Unregulated products can also vary in strength and purity.
Stories about individual children whose families believe cannabis helped their cancer are not a substitute for controlled clinical evidence. A child’s remission may reflect chemotherapy, other medical treatment, the natural biology of the disease, or several factors at once. Such accounts cannot show that THC or CBD caused the cancer to disappear.
Meanwhile, established neuroblastoma care continues to evolve. Treatments include risk-adapted chemotherapy and surgery, radiation, stem-cell rescue, targeted medicines, immunotherapy, and therapies directed at the GD2 protein on neuroblastoma cells. St. Jude researchers, for example, have described work on an improved GD2 antibody for neuroblastoma.
CBD may eventually prove useful as part of a carefully tested neuroblastoma therapy, but the 2016 study provides a rationale for further research—not evidence that medical cannabis treats or cures the disease. Families should discuss any cannabis- or CBD-containing product with the child’s oncology team and should not replace proven treatment with an unapproved product.
