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Thalidomide in patients with malignant pleural mesothelioma
Paul Baas1, Willem Boogerd, Otilia Dalesio
1Department of Thoracic Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. p.baas@nki.nl
Lung Cancer (Amsterdam, Netherlands)
|April 15, 2005
Summary
Thalidomide showed potential in treating malignant pleural mesothelioma (MPM), with 27.5% of patients experiencing over six months of disease stabilization. A dose of 200 mg/day is recommended for future studies due to milder toxicity.
Area of Science:
- Oncology
- Pharmacology
Background:
- Malignant pleural mesothelioma (MPM) is an aggressive cancer with limited treatment options.
- Anti-angiogenic agents are being explored for their therapeutic potential in MPM.
Purpose of the Study:
- To evaluate the efficacy and safety of thalidomide in patients with malignant pleural mesothelioma.
- To determine an optimal dose and toxicity profile for thalidomide in MPM treatment.
Main Methods:
- A cohort of 40 patients with confirmed MPM received oral thalidomide at escalating doses (100-400 mg).
- Patients were monitored for disease progression, toxicity, and neurological effects using sensory nerve action potential (SNAP) tests.
- Response was defined as disease stabilization for at least 6 months.
Main Results:
- Eleven patients (27.5%) achieved disease stabilization for over 6 months.
- The median survival was 230 days.
- The most common toxicity was constipation; grade II neurotoxicity occurred in two patients. A decline in SNAP tests did not correlate with neurological complaints.
Conclusions:
- A thalidomide dose of 200 mg/day is suggested for future MPM studies, offering mild toxicity.
- Routine neurological monitoring via SNAP tests may be unnecessary at this dose.
- The observed disease stabilization suggests thalidomide warrants further investigation in Phase III trials for MPM.