Thalidomide: the alien of the drug world

Most industries accept their failures, throw them on the scrap heap of broken dreams and move on. Not so the drugs industry, which is constantly looking at ways to use old drugs in novel ways, even discredited ones.

Arguably the most discredited drug of all time is thalidomide, the morning sickness pill that left the newborn terribly deformed. It spawned a drug regulation industry (for what it's worth) to ensure such a drug would never again be allowed on the market - except thalidomide never went away.

It started to reappear in the early 1990s in developing countries where there was little control of pharmaceutical drugs, and was finally granted a licence in 1998 as a treatment for leprosy.

Now, like Alien, it is mutating itself yet again, this time as a cancer drug. Two studies are finding that it's helping patients with multiple myeloma, a blood cancer, and melanoma, the skin cancer. When mixed with two other cancer drugs, thalidomide was more effective than standard chemotherapy, but at a considerable price. Twenty-six per cent of the 42 participants got infections, 19 per cent were treated for deadly blood clots, 14 per cent saw their white blood cells fall to an alarmingly low level, and 28 per cent were constipated. Two patients died, and 36 per cent had to stop thalidomide treatment because of the side effects. After that it takes a doctor to conclude that the drug is 'useful', as one said at the end of the trial.

Elsewhere, thalidomide is being mixed with other cancer drugs, but one trial in New York has just started, so it's too early to say what the effects might be.

Celgene Corp., thalidomide's manufacturer, is kindly funding both trials.

(Source: Journal of Clinical Oncology, July 1, 2004).

* The world of the pharmaceuticals is explored and exposed in the WDDTY book Secrets of the Drugs Industry. It's more of an eye opener than matchsticks! To order your copy, click on this link: http://www.wddty.co.uk/shop/details.asp?product=341