Phytocannabinoids for the Treatment of Chronic Chemotherapy-Induced Peripheral Neuropathy in Breast and Colon Cancer Survivors

This clinical trial tests how well phytocannabinoids (cannabidiol [CBD] and tetrahydrocannbinol [THC]) work in reducing chronic chemotherapy-induced peripheral neuropathy (CIPN) in breast and colon cancer survivors. Neuropathy is the most common neurological symptom reported by cancer patients due to treatment. A variety of pharmacologic treatments have been evaluated to alleviate CIPN symptoms; however, no definitive treatment has been found to successfully treat all the symptoms of CIPN. Therefore, investigators continue to seek other possible treatment options including cannabis. Phytocannabinoids may be a particularly useful intervention for cancer patients given the limited effective treatments for CIPN. In addition, cannabis-based medicines have become tremendously popular as both cancer patients and clinicians are seeking therapies with fewer potential risks of dependency and other side effects. This trial is being done to provide cancer patients and clinicians with reliable information to help guide their use of phytocannabinoids to manage the tremendous distress and pain experienced by many cancer patients, which impacts their long-term quality of life.

Inclusion Criteria:Documented informed consent of the participant and/or legally authorized representativeAssent, when appropriate, will be obtained per institutional guidelinesAgreement to allow the use of archival tissue from diagnostic tumor biopsiesIf unavailable, exceptions may be granted with study principal investigator (PI) approvalWillingness to comply with all study interventions including the use of medical cannabis and follow-up assessmentsAge: >= 18 yearsEastern Cooperative Oncology Group (ECOG) =< 2Ability to read and understand English for questionnairesPatients must have either neuropathy >= 1 according to Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0 scale or a neuropathy score of > 3 on a 0-10 scale plus a FACT/GOG-Ntx score of > 10The patient's previous chemotherapy treatment must have included a taxane (paclitaxel, nab-paclitaxel, or docetaxel) or platinum (cisplatin, oxaliplatin, or carboplatin) and considered the primary cause of the neuropathy by the medical teamTotal bilirubin =< 1.5 x upper limit of normal (ULN) (unless has Gilbert's disease)Aspartate aminotransferase (AST) =< 3 x ULNAlanine aminotransferase (ALT) =< 3 x ULNWomen of childbearing potential (WOCBP): negative urine or serum pregnancy test. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be requiredAgreement by females and males of childbearing potential to use an effective method of birth control or abstain from heterosexual activity for the course of the study through at least 1 months after the last dose of protocol therapyChildbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for > 1 year (women only)Current active treatment with chemotherapy, radiation or surgery in the past 3 months or planned treatment during this study protocol period. Note: Hormonal therapy is allowedExclusion Criteria:Concurrent use of other alternative medicines such as medical cannabis, herbal agents and high dose vitamins and mineralsLiver cirrhosis Child-Pugh B or CMental incapacitation or significant emotional or psychological disorder that, in the opinion of the investigators, precludes study entry (These patients may not be able to cooperate with this slightly invasive procedure or with the data collection process)History of diabetic neuropathy, neuropathy related to human immunodeficiency virus (HIV), or other medical causes of chronic neuropathy in the baseline assessment including past medical history, any history of diabetes, alcoholism, and vitamin B deficiencyPrevious medical cannabis use for any indication within 30 days of enrollmentPlanned or actual changes in type of medications that could affect symptoms related to CIPN. New medications for the treatment of CIPN are not allowed during the study.Note: Subjects need to be on stable doses of CIPN medications for 4 weeksStrong inhibitors or inducers of CYP3A4History of allergic reactions attributed to compounds of similar chemical or biologic composition to study agentClinically significant uncontrolled illnessDiagnosis of Gilbert's diseaseFemales only: Pregnant or breastfeedingAny other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study proceduresProspective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)