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Immunohistochemical expression of cannabinoid receptors in women’s cancers: what’s new?

  • Luca Roncati1,*,
  • Maria Vadalà2
  • Veronica Corazzari2
  • Beniamino Palmieri2

1Department of Maternal, Child and Adult Medical and Surgical Sciences, University Hospital of Modena, 41124 Modena, Italy

2Second Opinion Network, 41100 Modena, Italy

DOI: 10.31083/j.ejgo.2021.02.5463 Vol.42,Issue 2,April 2021 pp.193-195

Submitted: 03 January 2020 Accepted: 21 December 2020

Published: 15 April 2021

*Corresponding Author(s): Luca Roncati E-mail: luca.roncati@unimore.it;roncati.luca@aou.mo.it;emailmedical@gmail.com

Abstract

The cannabinoid receptors belong to the G protein-coupled receptor superfamily and are integral part of the endocannabinoid system. Two main types of cannabinoid receptors are known: cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2). In the last few years, great attention has been paid to the immunohistochemical evaluation of CB1 and CB2 expression in various types of tumors, including women’s cancers, for the alleged anticancer properties of cannabinoids. Today, in the modern era of precision oncology, monoclonal antibodies for the immunohistochemical evaluation of CB1 and CB2 expression are available on the market; therefore, our recommendation is to submit preliminary the formalin-fixed, paraffin-embedded, bioptic or surgical specimen of neoplastic tissue, containing at least 100 tumor cells and coming from the selected patient with no history of cannabis abuse, to predictive immunohistochemistry, before undertaking any cannabinoid-based therapeutic attempt, in association with conventional anticancer treatments or when the most advanced care is failing. The receptor expression is determined through a ‘tumor proportion score’ (TPS), which represents the percentage of viable neoplastic cells showing partial or complete membrane staining. By exploiting a methodology analogous to that applied for PD-L1 (programmed death-ligand 1) testing on cancer tissues, the specimen can be considered to have a high CB1 and/or CB2 expression if TPS 50%; a value between 1–49% corresponds to a low expression, while below 1% certifies no significant expression and, thus, no eligibility to a cannabinoid-based pharmacological approach.

Keywords

Cannabinoid receptors; Cannabinoid receptor 1 (CB1); Cannabinoid receptor 2 (CB2); Immunohistochemistry; Predictive immunohistochemistry; Tumor pro- portion score (TPS); Cancer

Cite and Share

Luca Roncati,Maria Vadalà,Veronica Corazzari,Beniamino Palmieri. Immunohistochemical expression of cannabinoid receptors in women’s cancers: what’s new?. European Journal of Gynaecological Oncology. 2021. 42(2);193-195.

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