Background: Patients with cancer express growing interest in using cannabis to alleviate symptoms and want information from their oncology care teams. However, most oncology clinicians report insufficient knowledge to discuss potential benefits and risks of cannabis with patients. Methods: We created the Cannabis and Cancer Research and Education Clinic (CanCaRE) to educate patients interested in cannabis use through 1:1 video consultations with an oncology advanced practice clinician. We also developed an electronic registry built in REDCap that tracks outcomes including NCI PRO-CTCAE symptom questionnaires. All patients receive an intake survey with questions about their diagnosis, cancer treatments, current symptom burden, cannabis use history, and current medications. Results: During the first 18 months of the CanCaRE clinic, 103 of the 130 patients seen for consultation completed the intake survey. All 16 of our clinic’s medical oncologists had at least one patient receive a consultation. Patients had diverse cancer diagnoses (breast (19%), gynecologic (15%), lung (11%), pancreas (11%)) and were more often white (84%), not currently using cannabis (74%), and female (60%), with a median age of 64 (range 26-92). Most respondents (41%) had stage IV disease with the remaining 32% stage I-III (28% unknown). Table outlines symptom burden at time of initial CanCaRE consultation. The percentage of patients using medications for symptoms was high; non-opioid analgesics (81%), antiemetics (52%), anxiety/depression meds (52%), sleep meds (39%), and opioids (30%). The most common initial cannabis product recommendation included an oral tablet/solution (2.5mg THC/2.5mg CBD) twice daily as well as a THC-dominant vaporizer (3-5mg THC per puff) as needed. Conclusions: The development of a cannabis clinic to provide patients with cancer personalized education and dosing guidance is novel and helps serve an unmet need. Patients have diverse cancer histories and express a high level of symptom burden. Patients and oncology care teams report high satisfaction with our clinic model. Initial cannabis dosing recommendations used a “start low, go slow” titration plan. Analysis has begun on cannabis use patterns and changes in symptoms/concomitant medications to further tailor recommendations that are safe, effective, and cost-efficient. Exploring ways to expand this clinic model to other cancer centers is underway.

^aNCI PRO-CTCAE severity items are rated on a scale of None, Mild, Moderate, Severe, and Very Severe.