Thalidomide: a new anticancer drug?
Experimental studies have demonstrated that thalidomide (Thal), a drug developed as a sedative, has antitumoural properties. The possible antitumour mechanisms of action involve: inhibition of angiogenesis, cytokine-mediated pathways, modulation of adhesion molecules, inhibition of cyclooxygenase-2 and stimulation of immuno response. Therefore, Thal is under clinical evaluation in oncology. This paper provides an overview of the data currently available in literature regarding, in terms of activity and toxicity, the use of Thal in cancer patients. Multiple myeloma is so far the most responsive malignancy. A moderate activity has been documented in certain solid tumours: glioblastoma multiforme, renal cell carcinoma and malignant melanoma. Tolerability is generally satisfactory with peripheral neuropathy being the most relevant dose-dependent toxicity. The more frequent, but moderate side effects are: somnolence, constipation, dizziness and fatigue. More studies are needed to properly evaluate the anticancer activity of Thal alone or in combination with other anticancer treatments. Preliminary studies suggest promising results of Thal in combinations with corticosteroids and cytotoxic drugs as front-line therapy of multiple myeloma. Regarding therapy of solid tumours in the adult, combination with chemotherapy, radiation therapy and molecular-targeting compounds are under investigation.
Fanelli
Massimo
M
Division of Clinical Oncology, San Filippo Neri Hospital, Rome, Italy.
Sarmiento
Roberta
R
Gattuso
Domenico
D
Carillio
Guido
G
Capaccetti
Barbara
B
Vacca
Angelo
A
Roccaro
Aldo Maria
AM
Gasparini
Giampietro
G
D000818:Animals; D000970:Antineoplastic Agents; D002100:Cachexia / Q000188:drug therapy / Q000209:etiology; D019337:Hematologic Neoplasms / Q000188:drug therapy; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D013792:Thalidomide / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D013792:Thalidomide