Thalidomide in Solid Tumors: The London Experience

Investigators at the Royal Marsden Hospital and University College in London have studied thalidomide (Thalomid) as both low-dose (100 mg orally, every night) and high-dose (600 mg, given as 300 mg twice per day)

ABSTRACT: Investigators at the Royal Marsden Hospital and UniversityCollege in London have studied thalidomide (Thalomid) as both low-dose (100 mgorally, every night) and high-dose (600 mg, given as 300 mg twice per day)therapy for patients with a variety of solid tumors. In the phase II low-dosestudy, responses were disappointing in patients with melanoma, ovarian cancer,and breast cancer. Results for patients with renal-cell carcinoma were moreencouraging. A case study of a patient with metastatic renal-cell carcinoma inthe lung and lymph nodes in the low-dose thalidomide study illustrates that (1)responses may be very slow; (2) the palliative response is separate from theoverall response, occurs much earlier, and is not consistent with anantiangiogenic action; and (3) peripheral neuropathy is a manageable sideeffect. Besides peripheral neuropathy, patients can experience severeconstipation (even on low doses) as well as headache, edema, and skin rash forwhich treatment recommendations can be made. Anecdotal benefits of thalidomideinclude enhanced or maintained appetite, improved sleeping, and reducedsweating. The high-dose study has been submitted for publication. [ONCOLOGY14(Suppl 13):17-20, 2000]

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