Adverse effects of thalidomide administration in patients with neoplastic diseases.
Thalidomide, a glutamic acid derivative, was withdrawn from clinical use in 1962 due to its severe teratogenic effects. Its recent reinstitution in clinical practice was related to its benefits in leprosy and multiple myeloma. Moreover, the antiangiogenic and immunomodulatory properties of thalidomide have led to its evaluation in several malignant diseases, including myelofibrosis, renal cell cancer, prostate cancer, and Kaposi sarcoma. However, thalidomide use is associated with several side effects: somnolence and constipation are the most common, while deep vein thrombosis and peripheral neuropathy are the most serious. A combination of thalidomide with steroids or chemotherapy is being evaluated in several phase 2 studies. While it is not yet clear whether these combinations will enhance efficacy, they appear to increase the toxicity of thalidomide, and thalidomide analogs are being developed to minimize this toxicity. Ongoing studies will clarify the potential advantages of these agents in the treatment of neoplastic diseases.
Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece. mdimop@med.uoa.gr
Meletios A
MA
Dimopoulos
Vagelis
V
Eleutherakis-Papaiakovou
D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000737:chemistry / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017322:Clinical Trials, Phase II as Topic; D003248:Constipation / Q000139:chemically induced; D004334:Drug Administration Schedule; D003875:Drug Eruptions / Q000209:etiology; D004359:Drug Therapy, Combination; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000737:chemistry / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced; D018579:Patient Selection; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D012894:Sleep Stages / Q000187:drug effects; D013723:Teratogens / Q000737:chemistry / Q000633:toxicity*; D013792:Thalidomide / Q000009:adverse effects* / Q000737:chemistry / Q000627:therapeutic use; D013997:Time Factors; D020246:Venous Thrombosis / Q000139:chemically induced
D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D013723:Teratogens; D013792:Thalidomide