More than 20 years ago, an epidemic of babies with horribly deformed arms and legs were born to women who had taken a sleeping pill called thalidomide. Test showed that thalidomide prevented the fetus from laying down blood vessels necessary to grow normal arms and legs. Twenty years earlier, Judah Folkman discovered that many solid cancers grow by producing chemicals that cause a person to grow huge blood vessels into the tumors. He theorized that if something could stop the growth of blood vessels into the tumors, the tumors would starve to death and disappear.

So for more than 20 years, doctors have known that they can kill tumors by preventing blood vessels from growing into them and that thalidomide may be the drug to do that and cure cancer. So far, researchers have shown that thalidomide helps prevent blood vessels from growing to a number of cancers including multiple myeloma, myelodysplastic syndromes, gliomas, Kaposi's sarcoma, renal cell carcinoma, advanced breast cancer, and colon cancer. At daily doses of 100 to 800mg, it controls one-third of multiple myeloma cancer patients who have failed treatment with everything else, and in more than half of patients treated early in the course of the disease. It is even more effective when combined with corticosteroids and chemotherapy in myeloma.

Thalidomide also controls one-third of patients with Kaposi's sarcoma, a lesser number of patients with renal cell cancer and high grade glioma brain tumors and, in combination with another drug, called irinotecan, in some patients with colon cancer. Thalidomide is being investigated currently in a number of clinical trials for cancer. Drowsiness, constipation and fatigue are common adverse effects seen in 75 percent of patients. Thirty percent suffer from nerve damage and skin rash. A few develop a slow heart rate or clots. The authors of several recent journal articles recommend that doctors prescribe thalidomide singly or in combination with other drugs, to all patients with myeloma cancer and some other cancers that have failed treatment.

Thalidomide in cancer - Potential uses and limitations. S Singhal, J Mehta. Biodrugs, 2001, Vol 15, Iss 3, pp 163-172. Singhal S, Northwestern Univ, Sch Med, Div Hematol Oncol, 676 N St Clair St, Suite 850, Chicago,IL 60611 USA

Checked 8/9/05

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