Author: Linda Rider

  • The FDA just refused to regulate CBD

    The FDA just refused to regulate CBD

    Over the past few years, CBD has rocketed to the forefront of the wellness industry, touted as a magical elixir that can treat all sorts of maladies, including pain, anxiety, stress, sleep disorders, diabetes, acne, depression, and even, according to some particularly bold claims, cancer.

    The limited research into the medical benefits and risks of CBD doesn’t support most of these cure-all assertions. But CBD’s rise in popularity — which began exploding in 2019 due to a confluence of consumer trends, including a boom in herbal supplements and the spread of marijuana legalization — was bolstered by the coronavirus pandemic as people sought out ways to alleviate the unique stresses of recent years. US sales reached $4.17 billion in 2022, and forecasts predicted that the market could quadruple by 2026.

    Today, you can buy CBD oil, vapes, tinctures, and edibles in convenience stores, gas stations, and smoke shops from Florida to Oregon. You can shop online and order everything from CBD bath bombs to dog treats; you can drink Goop-approved CBD cocktails or nosh on infused candy and cookies. The anxiety drug du jour seems to have found its way into every kind of lifestyle and household product imaginable. Nail polish? Check. Toothpicks? Yep! You can even buy a CBD pillow and bedsheets to infuse your sleep experience with maximum chill. It’s a Wild West time if you’re a hemp entrepreneur.

    But CBD, a cannabis compound also known as cannabidiol, exists in a gray area under federal law, and its exact legality has long been tricky to define. Any substance marketed as a supplement or food additive has to meet safety standards issued by the Food and Drug Administration, and that’s where things have gotten hairy for CBD manufacturers and marketers. Food and drinks that contain CBD have never actually been FDA-approved.

    For years, the FDA hasn’t come down one way or another with guidance on how to regulate, label, or market CBD in supplements and food products. So store shelves proliferated with quasi-legal tinctures and gummies and beverages, all taking advantage of the FDA gray area. The FDA has warned companies selling CBD products and consumers about unproven health claims made by manufacturers, steadfastly holding that CBD doesn’t meet the definition of a dietary supplement — a position that has been challenged by the industry and consumers as demand for CBD has boomed. Without regulation, however, there’s no way for a consumer to know what, exactly, is in that CBD they bought at the gas station — or if it contains any CBD at all.

    In late January, the agency finally issued a decision on CBD, and it’s a potentially damning blow to the industry. The FDA announced that it was denying three citizen petitions requesting guidance on CBD; the agency’s existing safety standards for supplements or food additives, it ruled, aren’t sufficient to regulate CBD’s use. Further, it expressed concerns that CBD products could be dangerous, especially with long-term use. Essentially, the FDA has said that CBD is a headache that it doesn’t want to deal with, so it’s kicking things over to Congress to sort out the mess.

    “We have not found adequate evidence to determine how much CBD can be consumed, and for how long, before causing harm,” FDA principal deputy commissioner Janet Woodcock said in a statement. “[A]fter careful review, the FDA has concluded that a new regulatory pathway for CBD is needed that balances individuals’ desire for access to CBD products with the regulatory oversight needed to manage risks.” The agency said that it would work with Congress to develop a new cross-agency regulatory framework for the substance.

    The past few years have been a trailblazing time for the CBD industry, with government oversight struggling to keep up with the burgeoning market. Will the FDA’s announcement force producers underground, or will the gray market continue to flourish while it awaits federal regulation?

    CBD oils are pictured at the Hudson Cannabis farm in Hudson, New York, in November 2022. “For immune and inflammation support” reads the bottle.
    Angus Mordant/Bloomberg via Getty Images

    Why CBD regulation has been so tricky

    Cannabidiol is an active ingredient found in the cannabis plant; it’s the second most abundant compound after its cousin tetrahydrocannabinol, a.k.a. THC. Unlike THC, CBD doesn’t cause the euphoric effect associated with marijuana. This is partly why it became so popular in recent years; because the compound is not considered psychoactive, cannabis-curious consumers believed they could reap health benefits from the plant without getting high.

    All hemp is cannabis, but not all cannabis is hemp. When the 2018 Farm Bill legalized hemp — defined as cannabis containing less than 0.3 percent THC — and its derivatives, including CBD, entrepreneurs saw dollar signs without the legalization and regulatory hurdles facing THC.

    Yet part of what’s hampered regulation of CBD is exactly what’s hampered regulation of THC: Research on cannabis compounds is nearly nonexistent in the United States since marijuana is still illegal under federal law. The Drug Enforcement Agency strictly limits marijuana cultivation for research, and the glacial pace of cannabis legalization means scientists and researchers have largely been unable to investigate the medical benefits and risks of cannabinoids, leaving agencies like the FDA with little hard data with which to make regulatory decisions.

    CBD, however, has been scientifically linked to the prevention of seizures, and the FDA has approved a prescription drug called Epidiolex that contains CBD as an active ingredient. This is largely also why the agency refuses to regulate other CBD products; a provision in the FDA’s Federal Food, Drug, and Cosmetic Act states that if a substance such as THC or CBD is an active ingredient in a drug that has been approved or is being investigated in clinical trials, any other products containing that substance are excluded from the definition of a dietary supplement. Because it’s an ingredient in a drug, the FDA argues, CBD cannot be used in food and drinks. Under current regulations, it’s even off the table for dog treats.

    Last August, bipartisan congressional lawmakers expressed frustration in a scathing letter to the FDA commissioner, over a bill that would have regulated hemp-derived CBD as a food additive. The lawmakers called out the agency’s brief response to their request for assistance crafting a regulatory framework as “completely insufficient.” Now that the FDA has punted oversight to Congress, the CBD industry is hopeful that change is finally underway. US Hemp Roundtable general counsel Jonathan Miller says legislation will be reintroduced in the House and Senate in the next few weeks. “We completely disagree with the FDA that they don’t have the authority to regulate CBD,” Miller told Vox. “What we do agree on is that it’s time for Congress to act.”

    Miller believes the FDA’s fixation on CBD as a pharmaceutical is misguided. “We completely disagree with their assessments on CBD safety,” he says. “The FDA is focused on the side effects of CBD products that have many thousands of milligrams per serving, as opposed to all the studies we’ve provided, measuring products typically sold in stores that contain 25, 30, 50 milligrams — studies that consistently show they don’t have adverse effects.”

    Over-the-counter access to hemp and CBD products is essential for people who use them as part of their wellness regimen, says Olivia Alexander, founder and CEO of the national topicals and wellness brand Kush Queen: “It’s especially necessary in states without access to adult-use cannabis and expensive medical markets.” Kush Queen provides lab results for products on its website, and Alexander counts her business among a few trusted CBD companies, including Charlotte’s Web, which is an official supplier to Major League Baseball. “But there are also tons of crazy fringe cannabinoid brands,” she says. “We need regulation.”

    In 2019, the National Cannabis Industry Association (NCIA) published a white paper outlining a framework for CBD products with four lanes of regulation, with pharmaceutical drugs at one end and CBD food and dietary supplements at the other. “We need to ensure that CBD is accurately labeled and that we’re careful about health-related claims being made on the packaging,” says NCIA director of communications Bethany Moore. “It should be regulated to protect public health, but it’s a low safety risk.”

    Hemp cultivators have also been hugely affected by federal inaction; some hemp advocates say the FDA has stifled the industry as the skyrocketing legal hemp supply tanked prices, leaving many farmers unable to cash in on their harvest. “There was tremendous excitement among farmers after the 2018 Farm Bill [which legalized the production and sale of hemp], and since then, because of the FDA’s lack of regulation, hemp and CBD biomass prices have crashed by more than 95 percent,” says Miller. “There’ve been a lot of bankruptcies, and many farmers have been left holding the bag.” He is hopeful that bipartisan support for hemp farmers in Congress will prevail. “Whether you’re talking about [Republican] Mitch McConnell or [Democrat] Ron Wyden — those two don’t agree on very much, but they both feel strongly about this.”

    A collective shrug from the gray market

    The FDA declined a request for an interview when Vox reached out to ask about what, if anything, will happen with existing products. Will they be pulled off shelves? Will the agency continue to issue warning letters to CBD businesses making health-related claims? Questions to the FDA went unanswered, but, given the speed at which federal regulators operate, the CBD gray market looks likely to keep chugging along for the time being.

    As the industry waits for Congress to pick up the regulatory baton, CBD shops and e-commerce sites across the country told Vox that they’re keeping calm and carrying on. When reached by phone, employees at CBD stores weren’t even aware of the FDA’s announcement; Vox spoke with retail employees and store owners in Rhode Island, Massachusetts, New York, Kentucky, and Missouri. “I can’t say I’ve noticed anything,” said an employee at a New York outlet of CBD Kratom, a chain with more than 50 retail locations nationwide. A worker at CBD World in Warwick, Rhode Island, also said she had yet to see any change in sales or store policy.

    A CBD Kratom retail store is pictured in New York’s Times Square.
    Lindsey Nicholson/UCG/Universal Images Group via Getty Images

    “This is my first time even hearing about it,” a staffer with SunMed CBD in Worcester, Massachusetts, told Vox, adding that he believes most customers don’t realize that CBD isn’t FDA-regulated. “I don’t think it’s made any kind of impact. The fact that I don’t know this information means your average person doesn’t know this information.” He said that customers who ask about CBD safety at SunMed are told to consult a physician if they have concerns about interactions with prescription drugs, and that all of their products have available lab results, including cannabinoid and terpene profiles, and information on potency, pesticides, herbicides, and heavy metals.

    The owner of the SunMed CBD store, Alex Valle, was also surprised to hear about the FDA announcement. “I hadn’t heard about it, but I think [regulation] is long overdue,” he said. “I think it’s fantastic, given that cannabis has been utilized for thousands of years. I’m glad they’re capable of moving forward with this.”

    While hemp and cannabis advocates hold out hope that the FDA’s decision will put pressure on Congress to regulate CBD and other cannabis products sensibly, it’s business as usual for most purveyors. “I’m just chilling until they get it together,” says Alexander, of Kush Queen. “The FDA announcement isn’t really going to affect us in any way.”

    For now, consumers will have to make their own decisions on whether to use CBD products, or wait for more data and regulation.

  • Columbia Care Celebrates Launch of Adult Use Cannabis Sales in Missouri | News

    Columbia Care Celebrates Launch of Adult Use Cannabis Sales in Missouri | News

    NEW YORK–(Enterprise WIRE)–Feb 6, 2023–

    Columbia Care Inc. (NEO: CCHW) (CSE: CCHW) (OTCQX: CCHWF) (FSE: 3LP) (“Columbia Care” or the “Company”), just one of the premier and most experienced cultivators, manufacturers and stores of hashish goods in the U.S., introduced it commenced adult-use profits on February 4 at its Cannabist i dispensary, situated in Hermann, Missouri. The dispensary has been serving the clinical affected person group considering the fact that 2021.

    “We are thrilled to see the swift action taken by the Department of Health and Senior Companies to bring leisure hashish to Missourians so before long after the ballot measure passed in November. It has been a privilege to run in these types of a promptly escalating marketplace and serve our patients in the neighborhood Hermann group. We search ahead to welcoming new buyers as a result of our doorways in the coming weeks and introducing them to our Cannabist experience,” reported Jesse Channon, Main Expansion Officer, Columbia Treatment.

    Cannabist Hermann presents a extensive selection of solutions as well as manufacturers, which include Columbia Care’s Amber, Classix, Hedy and Seed & Pressure. In addition to its dispensary in Hermann, the Firm also operates a producing facility in nearby Columbia, Missouri, which produces vapes, edibles and pre-rolls.

    For much more data, pay a visit to https://gocannabist.com/hermann.

    i Cannabist Hermann is managed by Columbia Treatment, LLC on behalf of Columbia Care MO, LLC by way of a managed providers arrangement.

    About Columbia Care

    Columbia Care is 1 of the premier and most seasoned cultivators, makers and vendors of hashish goods and connected providers, with licenses in 18 U.S. jurisdictions. Columbia Care operates 128 services which includes 95 dispensaries and 33 cultivation and producing facilities, together with people beneath enhancement. Columbia Care is one particular of the initial multi-state vendors of health-related cannabis in the U.S. and now delivers industry-foremost goods and expert services to equally the medical and grownup-use markets. In 2021, the firm introduced Cannabist, its new retail brand, creating a national dispensary network that leverages proprietary know-how platforms. The business features goods spanning flower, edibles, oils and tablets, and manufactures popular models including Seed & Strain, Triple Seven, Hedy, gLeaf, Classix, Push, and Amber. For more information on Columbia Treatment, you should visit www.columbia.care.

    Caution About Ahead-Hunting Statements

    This push launch has certain statements that constitute “forward-looking information” or “forward-on the lookout statements” within the indicating of relevant securities laws and reflect the Company’s present-day expectations concerning future activities. Ahead-searching statements or information and facts contained in this release include, but are not restricted to, statements or info with regard to the Company’s ability to execute on retail, wholesale, manufacturer and product or service initiatives. These ahead-wanting statements or details, which even though considered sensible by the Firm, could verify to be incorrect and are matter to recognised and unknown hazards and uncertainties that may well result in actual outcomes, performance or achievements of the Firm to be materially various from those people expressed or implied by any ahead-wanting information. These risks, uncertainties and other factors include things like, amid other folks, favorable running and financial disorders acquiring and retaining all expected licenses and permits favorable manufacturing amounts and sustainable expenses from the Company’s functions and the amount of demand for hashish products and solutions, such as the Company’s items bought by third functions. In addition, securityholders ought to assessment the danger factors mentioned underneath “Risk Factors” in Columbia Care’s Kind 10 dated May perhaps 9, 2022, filed with the applicable securities regulatory authorities and described from time to time in documents submitted by the Firm with Canadian and U.S. securities regulatory authorities.

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    Marketplace Search phrase: Alternate Medication Cannabis Health and fitness Buyer Women of all ages All-natural Sources Gentlemen

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    Copyright Business enterprise Wire 2023.

    PUB: 02/06/2023 08:05 AM/DISC: 02/06/2023 08:04 AM

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  • Health tips for fighting the winter blues

    Health tips for fighting the winter blues

    The holidays are around, the gifts are put away, and our social calendars are looking sparse this time of yr. The temptation is sturdy to keep within, binge observe Netflix and hardly leave the couch each weekend till spring arrives. Seasonal mood dysfunction is a actual point, in particular below in snowy upstate New York, exactly where a 40-diploma day is considered “delicate.” But being inside of and hiding out until finally wintertime is above does almost nothing to profit your psychological, actual physical or psychological health and fitness — rely on me. Right here are some matters you can do this winter season to maintain your strength and spirits large!

    Get exterior. I know you’re probably rolling your eyes and cursing my name, and that is comprehensible. But the advantages of obtaining exterior at the very least the moment a working day for a quick walk, to shovel or to go sledding with your kids are simple. Obtaining uncovered to cold is excellent for improving mental clarity, lymphatic drainage, preventing swelling and revving up our metabolic rate. If you costume heat, and keep your human body transferring, you could possibly surprise on your own that you do not truly feel cold at all, but unexpectedly content. As well as, winter is gorgeous! Choose the time to recognize the footprints in the snow from small animals, the 50 {fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}-melted snowman down the avenue, and how very the trees glimpse covered in snow. Get your coat and boots and get exterior this winter season — you will truly feel improved!

    People today are also reading…

    Make soup. Have you been craving warm, comforting foods on chilly winter times? That is completely regular! The eco-friendly salad you make daily for lunch abruptly doesn’t appear to be so appetizing. Our cravings for food items transform and fluctuate with the seasons, for the reason that our ancestors would normally only consume what was in year. Watermelon and cucumber salad may be cool and refreshing in July, but a finish turnoff in January. A sneaky way to even now get a great deal of veggies, but satisfy your cravings for heat, nourishing foods, is building selfmade soups. Chop up any veggies you want, insert some protein and broth, season to flavor and put it all in the Crockpot just before you go away for perform! You will occur household to the property smelling incredible, and a heat, healthy evening meal for you and your spouse and children.

    Strategy forward. We all have to have factors in the forthcoming yr forward to look ahead to. Now is a excellent time of year to plan a springtime vacation, indicator up for a race or party, or enroll on your own in a new class. Instead of shelling out months choosing what you want to achieve this 12 months, put by yourself in the incredibly hot seat by just signing up for the function! This will allow you to steer the ship this yr, and not make it possible for whatever daily life throws your way to dictate what you will achieve. If we hold out all-around to see what transpires this year, or hold out for a “fantastic time” to go back again to faculty, run a half marathon or go to Europe, the time will by no means arrive. Existence is generally going to be busy and chaotic, and points will often come up unexpectedly. But if you prepare in advance for the calendar year, you have functions lined up to retain you grounded and targeted on what way you are heading.







    Mara Casler

    Mara Casler




    Acquire baths. Tub time is no for a longer period reserved for the kids in the dwelling. Sitting in the tub can be difficult for busybody grownups, but can supply so several added benefits — particularly in the winter. Filling your tub with scorching water, Epsom salts and an important oil of your decision can be incredibly therapeutic for your muscle mass and your brain. Shelling out 10 minutes in the tub, visualizing, meditating or just enjoying some peace and tranquil can be a terrific coping mechanism for pressure at the conclusion of a long do the job 7 days. In its place of reaching for the wine and chips at the conclusion of the 7 days, would a 10-minute calming bathtub have the similar impact? Try it out!

    Wintertime can be a tough time for a lot of to truly feel happy, inspired and fired up about items. But it’s also a terrific time for setting up, clearing out, receiving great sleep, producing wholesome alternatives and paying time with men and women we adore. Get sunlight on your experience (even if it is driving the clouds), adjust out of the sweatpants, go for a wander, attempt new food items and remain in touch with your good friends this winter season. These smaller functions will help you sense better, ward off the winter season blues and keep you sensation content, healthful and fulfilled.

    Mara Casler, of Aurelius, is a licensed nutritionist by way of Cornell University, and retains a bachelor’s degree in exercise growth and a master’s diploma in recreation therapy from SUNY Cortland. She is a triathlete with a passion for weightlifting, climbing with her dog Oakley, and serving to folks develop into the healthiest model of on their own. 

  • Australia officially opens connected health research hub

    Australia officially opens connected health research hub

    The Australian Analysis Council has formally launched its most recent exploration hub for connected wellness at the University of New South Wales.

    Backed by A$24 million ($16.6 million) funding by the ARC’s Industrial Transformation Analysis System, the ARC Exploration Hub for Linked Sensors for Health focuses on establishing wearable well being systems.

    This new research hub, which turned operational in August, provides with each other 7 universities and 26 Australian organizations to build a countrywide finish-to-conclude ecosystem that will style, manufacture, and commercialise clinical-grade sensors and predictive analytics. It integrates existing Australian capabilities in sensors, security, software program units, facts analytics, and digital overall health.

    WHY IT Issues

    The investigate hub, which contains 37 main investigators and 26 associate investigators, seeks to “obtain a eyesight of building wearable systems for much better wellness that gains humanity.”

    In accordance to Professor Chun Wang, head of UNSW Engineering College of Mechanical and Manufacturing Engineering, “[c]onnected wellbeing sensors are emerging as a transformational know-how to address a vast variety of pressing challenges, these as remote health administration of persistent health conditions for at-chance populations, rehabilitation and chronic disease administration of frail and older people, checking acute ache and blood lactate degree in athletes, and smart rehabilitation and cure of neurological ailments.”

    THE More substantial Craze

    The Australian governing administration has constantly been eager to make improvements to the health checking of its citizens by investing in investigation jobs focusing on wearable overall health systems. In Oct, it supplied grants to 3 jobs that intend to boost the monitoring of wellbeing circumstances of patients with cerebral palsy, hypertension, and Form 2 diabetes.

    In 2021, the federal authorities created a A$10 million ($7 million) expenditure by means of the Clinical Investigate Potential Fund to help tasks that check new applications of existing wearable gadgets.

    ON THE File

    In a remark, ARC CEO Judi Zielke claimed the new connected sensors research hub “claims developments in wearable sensor systems that will direct to better health and fitness outcomes for Australians.”

    “It’s developments like people that will arrive from this Research Hub that will aid force Australian products up the global price chain, broadening our financial complexity and securing our source chains,” Australian Senator Tim Ayres, assistant minister for Trade and Manufacturing, also commented.

  • Canadian researchers cheer U.S. regulator’s push for tighter rules on CBD

    Canadian researchers cheer U.S. regulator’s push for tighter rules on CBD

    Canadian experts are applauding attempts by the U.S. Food stuff and Drug Administration to place tighter laws on cannabidiol (CBD), expressing extra study is needed into the prolonged-phrase outcomes of the hashish products, supplied its level of popularity as a intended heal for a selection of maladies. 

    The Food and drug administration past week requested Congress to let it create a regulatory framework for CBD, which is at the moment sure by number of if any guidelines beneath the U.S. Farm Act. The regulator states CBD-infused items — from gummies to sodas — generally fail to fulfill its foods security benchmarks. 

    “We have not discovered adequate evidence to establish how significantly CBD can be consumed, and for how prolonged, in advance of causing harm,” said Janet Woodcock, the FDA’s principal deputy commissioner, in a assertion.

    Her worries echoed all those of Canadian researchers, some of whom say CBD finished up in customer arms right before enough study, for the improper factors. Ottawa legalized cannabis for professional medical use in 2001, and for recreational use in 2018. 

    “I feel science ought to arrive right before politics and social tension. The safety of individuals should go to start with,” reported Dr. Gabriella Gobbi, a psychiatrist and neuroscientist, who researches psychological wellness issues at McGill University’s department of psychiatry.

    The Food and drug administration cited evidence of CBD’s potential risks to the liver, to the male reproductive process and of doable drug interactions. There’s also scant long-phrase data to forecast how use affects people over time.

    Watch | Everywhere you go, and not usually lawful: 

    CBD is located just about everywhere, from chocolate bars to pet treats, from encounter masks to moisturizers and bathtub bombs. A Market investigation has located hundreds of unlawful CBD products for sale.

    For example, some children produced liver issues immediately after using Epidiolex, the 1st Fda-permitted treatment to deal with seizures that contains CBD, according to a 2020 analyze that analyzed medical trials

    CBD is a compound located in cannabis, that can also be derived from hemp or parts of the cannabis plant with really low levels of the brain-altering THC.

    Gobbi claims the FDA’s move highlights the opportunity challenges and absence of information of a material infused in every thing from body oils to soreness relievers, and seen by many as harmless.

    The Fda wishes to address CBD more like a medication than a foodstuff or meals dietary supplement. In Canada CBD is infused in items from gummy candies to deal with creams. (Monthly bill Arnold/CBC)

    She also hopes the FDA’s stance drives need for superior scientific facts to identify what CBD is effective for, at what dose and with what possibility. She also hopes one day to see Epidiolex accessible in Canada.

    “Canada constantly appears to the U.S. and follows, so in all probability this will place force on Wellness Canada to … look superior at the pharmacological properties of CBD and go by means of far better regulatory benchmarks,” claimed Gobbi.

    Hance Clarke, medical director of the Pain Research Unit at Toronto General Healthcare facility, states he also hopes Canada will take be aware of the U.S. path. He states this country lacks regulation close to the $13-billion cannabis market and could use stricter principles to “retain Canadians protected” given rising investigate.

    CBD is a compound located in cannabis that can also be derived from hemp or components of the hashish plant with pretty low levels of the brain-altering substance THC. (Steven D’Souza/CBC)

    Strictly regulated

    Health and fitness Canada says CBD is already under strict regulations. The packaging must involve wellness warnings and they are prohibited from earning unproven well being or beauty claims.

    Well being Canada declined an interview ask for but in an electronic mail claimed the Cannabis Act regulates generation, distribution, sale and possession of hashish, which includes CBD.  

    Other than a several natural health and veterinary merchandise, all overall health solutions made up of hashish or CBD fall beneath the Food and Prescription drugs Act and go through extensive testing

    Toronto retiree Mike Parish bought fascinated in CBD after a nasty spill on his bike left him with a metallic pin in his arm. A mate proposed a CBD-infused topical for the pain. Parish says the products — labelled a “reduction stick” — seems to do the job.

    “I do not know if it’s just because I believe so much I want it to work — so it operates? I can slumber. So it performs,” stated Parish.

    He is one of many Canadians turning to CBD to solve myriad ills, inspite of a lack of medical proof of its usefulness, and substantial rates that insurance policies won’t cover.

    An oral administration syringe loaded with with substantial CBD hemp oil for managing a severely ill baby is shown at a non-public property in Colorado Springs, Colo. (Brennan Linsley/The Connected Press)

    James MacKillop, director of the Michael G. DeGroote Centre for Medicinal Hashish Investigate at McMaster College in Hamilton, says though CBD is low threat at small doses, it truly is not possibility cost-free.

    “There is, unfortunately, a fantasy that CBD is harmless,” he said.

    An pro overview at the Earth Health Organization suggested CBD is “non-addictive, not linked with possible human abuse” and lower-hazard plenty of to legalize.

    But the July 2022 report also observed problems about dosing, liver problems and drug interactions.

    It also famous that about-intake “could lead to disagreeable but slight facet outcomes such as diarrhea.”

    MacKillop claims research from a long time ago on rats and sea urchins confirmed harmful effects on sperm counts — but says the only human review showed no outcomes.

    A jar of marijuana shaped gummies.
    Many Canadians are turning to CBD-infused products to address myriad ills, despite a lack of clinical evidence of success, and significant charges that insurance policy will not cover. (Gavin Jones/Shutterstock)

    When he’s not overly worried about the risks of CBD, MacKillop says more research is necessary and medical trials are prohibitively complicated to mount in this nation.

    “If one thing is powerful adequate to take care of a problem, it can be possibly sturdy ample to have some unwanted facet consequences and be dangerous also,” he said.

    MacKillop is at this time establishing a study of the effects of CBD-infused drinks. He suggests it can be mysterious how they interact with alcohol and other medication.

    He states Canada’s existing laws make it “considerably less of a ‘wild west’ environment” than in the U.S. 

    “And that’s most likely for the very good of individuals.”

    MacKillop concedes CBD is not intoxicating or addictive and it is really anecdotally credited to aid with a “laundry record” of ills — from weak sleep and stress, to soreness, habit and even PTSD. But he says there’s nevertheless not enough significant-excellent exploration on its effects. 

    “CBD — and actually all of the obtainable hashish products — exist in a quite murky and gray area when it arrives to proof. You can find a lot extra lore…than there is great proof,” claimed MacKillop.

  • From Clinical Trials to Real-World Practice, Experts Examine the Best Options for TNBC

    From Clinical Trials to Real-World Practice, Experts Examine the Best Options for TNBC

    CancerNetwork® recently hosted a first-of-its-kind Tweet Chat with co-hosts Hope S. Rugo, MD, and Paolo Tarantino, MD. Together, they reviewed a patient case of a 52-year-old woman who had been diagnosed with stage IIA triple-negative breast cancer (TNBC) and went into detail regarding treatment options for the metastatic population.

    Rugo, a professor of medicine, and director of Breast Oncology and Clinical Trials Education at the University of California San Francisco Helen Diller Comprehensive Cancer Center; and Tarantino, a Clinical Research Fellow at Dana-Farber Cancer Institute, also examined the use of neoadjuvant therapeutics for early disease and potential adjuvant therapy-sparing regimens.

    During the live Tweet Chat, both experts detailed the impact of antibody-drug conjugates (ADCs) on survival outcomes and the best approach for treating patients following disease recurrence after first-line therapy.

    In the first part of the patient case of a 52-year-old woman with stage IIA TNBC, Rugo mentioned the need for neoadjuvant chemotherapy, “We recommend [neoadjuvant chemotherapy] in this case, following the KN522 regimen. The [addition] of [pembrolizumab increases] pCR and EFS. @SABCS22 Gupta showed better outcomes adding platinum to T/[adjuvant chemotherapy].”

    Tarantino responded with results from the phase 3 KEYNOTE-522 trial (NCT03036488) wherein patients with TNBC received pembrolizumab (Keytruda) plus chemotherapy vs placebo as a neoadjuvant treatment and pembrolizumab vs placebo as adjuvant treatment.1

    Rugo questioned if there is a need to wait a year after starting pembrolizumab for a partial complete response (pCR) to be observed and, if not, whether capecitabine/pembrolizumab is a good alternative treatment option.

    Additionally, she introduced several studies assessing sacituzumab govitecan-nxki (Trodelvy) in patients with TNBC, “OptimICE pCR is an ALLIANCE trial that will randomize [patients] to [pembrolizumab] or not in those with pCR. OptimICE RD and the [phase 3] SASCIA trial [NCT04595565] are evaluating the addition of sacituzumab govitecan in patients with residual disease.”

    In response, Tarantino discussed data from phase 2 GeparNuevo trial (NCT02685059) which added a PD-L1 antibody to taxane chemotherapy.2 In this trial, patients had a high invasive disease-free survival. While OptimICE-pCR is still enrolling patients, he hopes that the results will show the ability to spare adjuvant immunotherapy.

    Next steps of treatment was also a topic of conversation, as the patient experienced recurrence after adjuvant capecitabine and radiation.

    Tarantino responded that chemotherapy and taxane rechallenge is the current standard of care for recurrent TNBC, “[Chemotherapy], with a taxane rechallenge [is] reasonable given [the] long time since completion of [adjuvant taxane].”

    When asked if she agreed with his reasoning behind using taxane in the first-line setting and sacituzumab govitecan in the second-line, Rugo mentioned the phase 3 ASCENT trial (NCT02574455), which had final data read out at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, supported this thought process She mentions that this trial then led to the approval of sacituzumab govitecan in the second-line setting for patients with TNBC.3,4

    Another study that was presented at ASCO and, according to Tarantino, showed impressive results was the phase 3 DESTINY-Breast04 trial (NCT03734029) which analyzed fam-trastuzumab deruxtecan-nkxi (Enhertu) in patients with HER2-low breast cancer.5

    In response to data from the DESTINY-Breast04 trial that Tarantino presented, Rugo said, “Really incredible data from DB04 for HR+ and encouraging in TNBC; just [important] to remember that [there were] only 58 pts so 18 in the control arm. And only 1/3 of TNBC [cases] are HER2 low.”

    Rugo also mentioned the ongoing phase 3 ASCENT-03 trial (NCT05382299) examining sacituzumab govitecan vs physician’s choice therapy in previously untreated metastatic TNBC. There is also the phase 3 ASCENT-04 trial (NCT05382286) assessing sacituzumab govitecan plus pembrolizumab vs physician’s choice plus pembrolizumab previously untreated, locally advanced inoperable or metastatic TNBC. Both of these trials utilized sacituzumab govitecan as second-line treatment.

    Tarantino and Rugo also touched on trials involving ADCs such as the phase 1/2 BEGONIA trial (NCT03742102), assessing durvalumab (Imfinzi), capivasertib, oleclumab, paclitaxel, trastuzumab deruxtecan, and datopotamab deruxtecan for patients with metastatic TNBC.6 To better support the data presented with BEGONIA, Tarantino posted a graphic detailing the change from baseline target lesion size and the change from baseline of the number of target lesions over time.

    When asked how they would treat a patient if progression occurred 3 months after initial treatment with first-line therapy, Rugo responded, “Good question, and tragic situation; in this case, we treat as if we are second line, so [we] would use sacituzumab govitecan first-line. At least that is my approach. @PTarantinoMD?If PD-L1 positive how would you treat?”

    Tarantino noted that if a patient is PD-L1 positive, it is worth it to combine first-line pembrolizumab plus chemotherapy. He referenced the phase 3 KEYNOTE-355 trial (NCT02819518) as an example of when to use this treatment combination.7

    Rugo agreed with Tarantino’s recommended course of action, but questioned if the patient was on single arm pembrolizumab at the time of progression, what should be the standard of care? Tarantino noted this was a hard question but said that he would be inclined to administer treatment as though the patient was in the second line, moving to an ADC.

    He then inquired if the patient had a BRCA mutation, would it change the choice of treatment.

    Rugo responded with results from the phase 3 OlympiAD trial (NCT02000622) that focused on the use of olaparib in patients with a BRCA mutation.

    Survival was also improved in the phase 3 EMBRACA trial (NCT01945775), assessing talazoparib in patients with advanced breast cancer who had a germline BRCA mutation.

    In closing, Rugo said she is interested in seeing outcomes with the use of maintenance PARP inhibitors after response is achieved, specifically those with BRCA mutations. Tarantino responded that PARP maintenance is a very interesting strategy and could even have use in other populations outside of those with BRCA mutations.

    To view the full Tweet Chat, visit, https://bit.ly/3XKj1bk

    References

    1. Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020;382(9):810-821. doi:10.1056/NEJMoa1910549
    2. Loibl S, Schneeweiss A, Huober J, et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol. 2022;33(11):1149-1158. doi:10.1016/j.annonc.2022.07.1940
    3. Final data from phase 3 ASCENT study demonstrates Trodelvy extends overall survival over chemotherapy in second-line metastatic TNBC. News release. Gilead. June 6, 2022. Accessed January 27, 2022. https://bit.ly/40aDYh8
    4. FDA grants regular approval to sacituzumab govitecan for triple-negative breast cancer. News release. FDA. April 7, 2021. Accessed January 27, 2023. https://bit.ly/3Hae98x
    5. Modi S, Jacot W, Yamashita T, et al. Trastuzumab deruxtecan in previously treated HER2-low advanced breast cancer. N Engl J Med. 2022; 387(1):9-20. doi:10.1056/NEJMoa2203690
    6. Loibl S, Schneeweiss A, Huober J, et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol. 2022;33(11):1149-1158. doi:10.1016/j.annonc.2022.07.1940
    7. Cortes J, Rugo HS, Cescon DW, et al. Pembrolizumab plus chemotherapy in advanced triple-negative breast cancer. N Engl J Med. 2022;387(3):217-226. doi:10.1056/NEJMoa2202809