Prof Meera Agar to undertake Australia’s first medical cannabis trial

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The NSW Government commits $9 million towards the  project

Associate Professor Meera Agar, Chief Investigator and Chair for ImPACCT (Improving Palliative Care Through Clinical Trials), will lead Australia’s first medical cannabis trial for terminally ill adults.
The ambitious initiative, announced recently, will see the NSW government injecting $9 million into the project, positioning the state at the forefront of world-class research in this area. Medical marijuana, as it is otherwise known, is a contentious issue that has divided the nation, particularly the research fraternity.
The trials aim to develop a deeper insight into ethically sourced cannabis products and its efficacy in alleviating pain and improving quality of life in patients with end-stage cancer. It seeks to complement the existing palliative care treatments and therapies patients receive.

“We do not want patients or carers having to play pharmacist – that is why it is so important to explore the safest and most effective ways we can deliver compassionate care,” Premier Mike Baird stated.

“This trial could not be in more experienced hands,” Minister for Medical Research Pru Goward added. “Professor Agar has led several important research studies into the management of patients with terminal illness and together with her team has many years of combined experience.”
Agar, who has several academic appointments in palliative medicine at UNSW, Sydney University and Flinders University, is the Clinical Director of the Palliative Care Service at Braeside Hospital, Research leader for the SWSLHD Clinical Trials Unit and the Palliative Care Service as well as the Clinical Trials Director at the Ingham Institute of Applied Medical Research. Her research interests inform clinical care across palliative medicine, with the primary focus being improvement in quality of life.
She has won numerous grants and awards including the prestigious European Association for Palliative Care 2013 Early Career Researcher Award and 2011 New South Wales Premier’s Cancer Research Award for Innovation in clinical trials.
“Terminally ill patients deserve quality care,” Agar told Indian Link. “It is wonderful that Australia is leading the way in so many crucial areas of palliative care research including clinical trials through government funded initiatives.”
Through the controlled study, which gets underway early next year, Agar will examine the therapeutic value of two types of cannabis products – vaporised leaf cannabis and a pharmaceutical version, delivered to patients through a routine clinical practice in safe and reliable way. Her study will focus on loss of appetite as a predominant symptom with limited treatment, causing considerable distress not just to patients but their carers and extended family.
“Cancer affects the biology of taste, appetite and hunger and so we hope medical cannabis will work on neural pathways and stimulate appetite, thereby increasing food taking and sharing food with family,” Agar explained.

It will also assess the potential ability of cannabis to alleviate other symptoms including fatigue, altered taste and smell for food, low mood, weight loss, nausea, insomnia and the ability to provide pain relief and enhance overall quality of life.

While trial studies looking at appetite have been conducted elsewhere in the world, in terms of delivery system, this pilot will clearly put Australia ahead on healthcare map.

“We hope to collect real data to maximise symptom control with minimum harm. This will add to the existing body of evidence-based research to help better understand and evaluate the potential benefits that medical cannabis products may have for terminally ill patients,” Agar noted.
Undertaken in two parts, the trial will also examine ideal dosage, frequency of usage, tolerance thresholds and potential side effects. Blood serum levels will be carefully monitored during the study to assess benefits. Mood alterations as well as interaction with other cancer drugs are some of the side effects Agar will closely evaluate.
Part I will enrol approximately 30 patients and is to be conducted at the Calvary Mater Newcastle Hospital.
Once the results are collated, Part II (slated for late 2016) could potentially expand to a broader range of patients across metropolitan and regional hospitals.
The trial will be reviewed by human research ethics committee and conducted strictly in accordance with the standard ethical process.
The NSW Government has also established the Centre for Medicinal Cannabis Research and Innovation to further understanding of cannabis and cannabis products for therapeutic purposes, and support evidence-based innovation.
Working closely with organisations such as the Lambert Initiative, established recently through a $33.7 million donation to Sydney University, it will draw on local and international expertise.
The Centre will receive $12 million in funding over four years in addition to the $9 million already committed for clinical trials.

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