Medical Cannabis, Enecta interviews Doctor Massimo Nabissi

What does Doctor Nabissi expect, from his point of view - that of a scientific researcher -,  or what are his auspices for 2018 regarding Medical Cannabis?  

In the past years, the argument “Medical Cannabis” has met with significant attention outside the official scientific channels,  making it possible for the major part of the population to obtain information about the therapeutic use of Cannabis.

The many seminars, debates, newspaper articles and online news articles have made it possible to get to know more about Cannabis and its derived products from a curative point of view, with the result to have triggered interest amongst the population.

This media condition has certainly stimulated the operators in the health sector to gather more information about the medical use of Cannabis and this is highlighted also by the increasing number of seminars requested by the Italian Faculties of Medicine. In addition, the first specialization course on cannabis at the University of Padua is certainly an important signal, which will generate an ever higher interest in the science of Cannabis.

In the near future I think and I hope that the world of Cannabis will be more and more at the focus of interest of patients, physicians, pharmacists and that the hardly scientific, cultural heritage will be cancelled bit by bit.

I also hope that regarding pre-clinical and clinical research, a financing programme will be activated to sustain the numerous possible studies related to the research of the therapeutic potentials and effects of Cannabis and its derivatives in various diseases, which currently are poorly treatable at pharmacological level.  
 
You have conducted important research on the effects of Cannabis on the tumour cells of glioblastoma and myeloma, what are your findings?

As a laboratory of pre-clinical research, we have conducted several studies related to the effects of THC and CBD in glioblastoma and multiple myeloma. The generated data has appeared in scientific publications and has contributed to initiating the first clinical trial in patients with glioblastoma.
For multiple myeloma, the obtained data has been object of interest and taken into consideration for initiating clinical studies, currently in process of development.
 
Can we affirm that Cannabis could defeat cancer?

I don’t think it is possible to find one single treatment to fight cancer, also because there are many forms of cancer which are very different  from each other and each type of tumour would require a targeted therapy.  

Cannabinoids have shown (in pre-clinical studies) to work well in several forms of cancer (lung, breast, glioblastoma, pancreas, prostate, multiple myeloma, melanoma), acting as an anti-tumoral and improving the biological response of chemotherapeutics, when used in combination with cannabinoids.

Thus, when spoken of or published about “the molecule curing cancer”, whichever molecule it may be, it’s a scientifically incorrect way of explaining a scientific result whcih risks to delude cancer patients.  

Regarding cannabinoids one can speak about biological effectiveness (intended as anti-tumoral activity) in the models of tumours already studied; in other types of tumours there is no scientific data available yet. 
 
Are there enough clinical studies in Italy to assert that Cannabis can be used by the patients safely?

There are many clinical studies confirming the non-toxic dosages of Cannabis patients can use. On the other hand, we still do not have accurate records regarding dosages and indications on administration to be applied in each specific disease.  

But this aspect should not be a limit to the interest in the therapeutic use of Cannabis, but even stimulate clinical trials. Certainly toxicity of Cannabis is considerably lower to that of many drugs currently in use for various diseases.
 
What does it mean to do research in Italy today?

Italy is currently one of the very few countries in which one can do research on Cannabis derivatives, even though with some difficulties and mostly without the support of funding specifically aimed to the research of derivatives of Medical Cannabis.

With regards to the research on multiple myeloma, our efforts have been taken as a reference for the registration of a patent on the use of Cannabis derivatives, filed by two foreign pharmaceutical companies.

There is much information circulating on the Web, is there a risk to come across news which doesn’t correspond to the truth; Cannabis isn’t a “magic wand” that can be used in all cases, What can you suggest to people looking for Medical Cannabis?

My advice is to get information from physicians prescribers of Cannabis, in Italy present throughout the territory and to contact official sites. In addition, the various web sites, Facebook pages and blogs one can reach through internet can certainly give their precious contribution to obtain basic information on the subject. one can then further explore with experts in the field. 
 
In a conference held in Perugia you talked about the “wellbeing of the patient”, a concept I think addresses the issue of the quality of life during disease; what kind off added value can Cannabis bring?

Wellbeing of the patient is an essential therapeutic result, which should never be disregarded in the patient’s therapy. The pharmacological combinations should reduce, eliminate or slow down the progression of the disease, but if the therapy has such toxicity as to create an additional malaise to the discomfort already created by the disease itself, inclusion of other medical treatments aimed to the reduction of the patient’s distress should be taken into consideration.

Cannabis is also studied for its adjuvant properties in several therapies (oncologic, chronical inflammation, neurodegenerative, etc.), as a drug that improves the sense of wellbeing of the patient. In this area of clinical research I’m very optimistic in thinking that one day Cannabis therapy will be able to give added value to current therapies.

Interview by Giuseppe Cantelmi