
<b>From M about her use of thalidomide:</b>
I took thalidomide 18 months for GIST, 1 gram per day.  I received 4 months of stable disease, which occurred between month 2 and month 6 of the treatment. Evidently, thalidomide requires a few weeks before its effect "kicks in."  

I continued with thalidomide though my tumors resumed growth.  I have a general impression that they grew at a slower rate than they had at other times.  

Side effects were easy to tolerate, and included somnolence, fatigue, constipation, gradual hair loss, ...and later and serious--peripheral neuropathy [nerve damage in my feet.]  
1 gram per day is a fairly high dose.  

It's addictive. I liked taking it.

I know of one other individual with a GI tumor, who claimed some level of stable disease with thalidomide.  I also remember two other individuals, one with a uterine primary and the other kidney primary, for whom thalidomide was not effective.

M


<b>Thalidomide is used in the treatment of:</b>
Various symptoms of leprosy, TB, and other mycobacterial infections
HIV wasting syndrome and other HIV conditions
Recurrent aphthous stomatitis of the terminally immunocompromised
Prevention and treatment of graft-versus-host disease [bone transplant pts]
Crohn's disease
Behcet's Syndrome
A variety of inflammatory and skin disorders
In cachectic patients with advanced cancer, thalidomide may provide benefits in terms of improvement in symptoms of insomnia, nausea, and poor appetite, and an increase in feelings of well being.

Many of these have an outraged and overactive immune system as a common factor.  Thalidomide evidently moderates the immune reactions in these conditions, and this has been called an <b>"immunomodulatory"</b> property.

Thalidomide is also being used for treatment of primary brain tumors, multiple myeloma, and various other malignancies.  It is thought that <b>antiangiogenesis</b> properties of thalidomide play a role here.  That thalidomide can cross the blood brain barrier to have an effect on some primary brain tumors is also quite useful.


<b>Thalidomide in the Treatment of Neoplastic Diseases</b>
Thalidomide is being evaluated for the treatment of a variety of cancers, and is also being prescribed off-label for many others, as a single agent disease stabilizer.  There are also ongoing trials with thalidomide as one in a combination of chemotherapy agents.

There have been trial results published on thalidomide's efficacy in Kaposi's sarcoma, melanoma, multiple myeloma, ovarian cancer, primary brain tumors (recurrent high-grade astrocytomas and mixed gliomas), androgen-independent prostate cancer, various advanced solid tumor malignancies,  and renal carcinoma.  Further studies are necessary to establish safety, efficacy, and optimal dosages and combinations. 
