Dr Stephen Barnhill M.D from Apollon Formularies Plc discusses the potential for technology to upgrade personalised medicine for cannabis treatments
With over 70% of new cancer drugs being derived from natural products, the future of medicine lies within nature. For centuries, the plant Cannabis sativa L. has been used across the world as a herbal remedy.
Modern research has shown its potential to treat various diseases such as cancer. Technology is taking treatment a step further with the potential to 3D print personalised cannabis-based medicines in local pharmacies.
Going back to nature
In the last century, there has been a trend within the pharmaceutical industry of new cancer drugs being derived from natural sources [1]. According to research by Newman & Cragg 2010, “in the area of cancer, over the time frame from around the 1940s to date, of the 175 small molecules, 131, or 74.8%, are other than “S” (synthetic), with 85, or 48.6%, actually being either natural products or directly derived therefrom”.
The acceptance of plant-based medicines is also apparent in public attitudes towards medical cannabis. After its 50 year prohibition in the UK, medical cannabis was legalised in 2018 sparking renewed interest and research into the plant’s properties.
Alongside its stand-alone properties, medical cannabis formulations can be used with other naturally-derived medicines to enhance efficacy. For example, independent testing showed that when medical cannabis and functional mushroom formulations were combined, nearly 100% of HER2+ breast cancer cells in 3D cell cultures were killed through the three different pathways [2]. These compelling results have warranted the initiation of human trials and mark a significant milestone in cannabis’ potential role in oncology.
As cannabis-based medicines move away from the ‘novel’ and into the mainstream, we should continually be looking towards the future and how it can fit into new approaches to drug design.
There’s no ‘one size fits all’ for our health
Changes in drug development and manufacturing within the last century have led to a ‘one size fits all’ approach to our health [3]. Many mainstream medicines are mass produced based on broad population averages, meaning that the true efficacy for an individual could be significantly different depending on their genome [3].
Personalised medicine recognises that we are all genetically unique which has allowed gene-based biomarker therapeutic triage in certain individual cancer patients. Gene sequencing to identify new biomarkers for medical cannabis patients, like is currently used in some traditional cancer treatments, is currently underway.
With over 100 naturally occurring cannabinoids, there is no ‘one size fits all’ for medical cannabis in cancer treatment [4]. As discussed in the March 16 2022 article, AI is being used to carry out analysis of cannabis plant genetics and phenotypes, to determine the best combination of cannabinoids, terpenes and flavonoids to target and optimise the treatment of various cancers.
Modernising an ancient medicine
Personalised medicine raises the question of commerciality; how can pharmaceutical companies mass produce individual treatments?
One solution is three-dimension (3D) printing, which came into the mainstream during the 2000s [5] and ‘involves the establishment of a three-dimensional object, in a layer upon layer manner using various computer software’ [6]. Since the Food and Drug Administration in the United States approved the first 3D-printed drug in 2015, there has been growing interest in its application in the pharmaceutical sector [7].
Advances in technology mean that 3D printing has a range of printing methods which are compatible with printing drug products [7]. This allows the creation of 3D-printed medicines with dosage forms varying in drug combination, release profile and shape to meet individual needs [6].
As 3D printing moves towards the mainstream, companies such as Apollon Formularies are researching its application with cannabis-based medicines. The confluence of this powerful technology and the huge potential of medical cannabis in the treatment of a number of diseases makes for a compelling future of personalised healthcare.
The ambition is to have 3D printing available in local pharmacies, where pharmaceutical companies would be able to send the printer the combination of compounds for on-demand printing of personalised medication. This would also allow for medicines with short-shelf lives to be produced in a timelier manner. Whilst we are still years away from making this aspiration a reality, the fundamental technology is firmly rooted.
References
[1] Newman, D. J., & Cragg, G. M. (2012). Natural products as sources of new drugs over the 30 years from 1981 to 2010. Journal of natural products, 75(3), 311–335. https://doi.org/10.1021/np200906s
[2] Apollon Formularies Plc, https://polaris.brighterir.com/ public/apollon_formularies/news/rns/story/r726zjw, Accessed May 2022
[3] The Jackson Laboratory, https://www.jax.org/personalized-medicine/precision-medicine-and-you/what-is-precision-medicine, Accessed May 2022
[4] Open Access Government, https://www.openaccessgovernment.org/medical-cannabis-cancer-treatments/131741/, Accessed May 2022
[5] Sculpteo, https://www.sculpteo.com/en/3d-learning-hub/basics-of-3d-printing/the-history-of-3d-printing/, Accessed May 2022
[6] Vaz, V. M., & Kumar, L. (2021). 3D printing as a promising tool in personalized medicine. AAPS PharmSciTech, 22(1), 1-20.
[7] Lepowsky, E., & Tasoglu, S. (2017). 3D printing for drug manufacturing: A perspective on the future of pharmaceuticals. International journal of bioprinting, 4(1), 119. https://doi.org/10.18063/IJB.v4i1.119
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