Thalidomide was first marketed in Europe in the late 1950's. It was used as a sleeping pill and to treat morning sickness during pregnancy. At that time no one knew thalidomide caused birth defects.
In 1961 scientists discovered that the medication stunted the growth of fetal arms and legs.

Researchers from Queen Alexandra Hospital, Portsmouth, UK, assessed the safety and efficacy of Thalidomide in attenuating weight loss in patients with cachexia secondary to advanced pancreatic cancer.

They studied a group of fifty patients with advanced pancreatic cancer who had lost at least 10% of their body weight.

The patients were randomised to receive Thalidomide 200 mg daily or placebo for 24 weeks.

The primary outcome was change in weight and nutritional status.

At four weeks, patients who received Tthalidomide had gained on average 0.37 kg in weight and 1.0 cm3 in arm muscle mass compared with a loss of 2.21 kg ( absolute difference –2.59 kg ; p = 0.005 ) and 4.46 cm3 ( absolute difference –5.6 cm3; p = 0.002 ) in the placebo group.

At eight weeks, patients in the Thalidomide group had lost 0.06 kg in weight and 0.5 cm3 in arm muscle mass compared with a loss of 3.62 kg ( absolute difference –3.57 kg; p = 0.034 ) and 8.4 cm3 ( absolute difference –7.9 cm3; p = 0.014 ) in the placebo group.

According to study results, Thalidomide was well tolerated and effective at attenuating loss of weight and lean body mass in patients with cachexia due to advanced pancreatic cancer.

Cytokines, especially tumour necrosis factor alpha ( TNF-alpha ), play an important role in the development of cancer cachexia.
Thalidomide is an inhibitor of TNF-alpha synthesis.

Source: Gut, 2005


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