Thalomid’s adverse effect profile continues to be reassuring, given that physicians know to avoid using thalidomide during pregnancy. In spite of delays in gaining approval for the treatment of multiple myeloma, we expect that Thalomid will become an important part of the management of several indications. In addition to multiple myeloma, Thalomid is being tested in late-stage trials relating to non-specific immune disorders, apthous ulcers, and AIDS wasting syndrome. Thalomid is in mid- and late-stage programs in HIV-related diarrhea, AIDS-related Kaposi sarcoma, leukemia, and various solid tumors. Thalomid is currently used off-label in Crohn disease, and has generated encouraging mid-phase data in the management of Waldenström macroglobulinemia, myelodysplastic syndrome, metastatic melanoma, and inflammatory bowel disease. The jury is still out on Thalomid’s ability to treat conditions such as refractory pediatric malignancies and metastatic renal (kidney) cell carcinoma.

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