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The antiangiogenic effects of thalidomide have been assessed in clinical trials in patients with various solid and haematological malignancies. Thalidomide blocks the activity of angiogenic agents including bFGF, VEGF and IL-6. We undertook an open-label study using thalidomide 100 mg once daily for up to 6 months in 20 men with androgen-independent prostate cancer. The mean time of study was 109 days (median 107, range 4-184 days). Patients underwent regular measurement of prostate-specific antigen (PSA), urea and electrolytes, serum bFGF and VEGF. Three men (15%) showed a decline in serum PSA of at least 50%, sustained throughout treatment. Of 16 men treated for at least 2 months, six (37.5%) showed a fall in absolute PSA by a median of 48%. Increasing levels of serum bFGF and VEGF were associated with progressive disease; five of six men who demonstrated a fall in PSA also showed a decline in bFGF and VEGF levels, and three of four men with a rising PSA showed an increase in both growth factors. Adverse effects included constipation, morning drowsiness, dizziness and rash, and resulted in withdrawal from the study by three men. Evidence of peripheral sensory neuropathy was found in nine of 13 men before treatment. In the seven men who completed six months on thalidomide, subclinical evidence of peripheral neuropathy was found in four before treatment, but in all seven at repeat testing. The findings indicate that thalidomide may be an option for patients who have failed other forms of therapy, provided close follow-up is maintained for development of peripheral neuropathy.

Original publication

DOI

10.1038/sj.bjc.6600817

Type

Journal article

Journal

Br J Cancer

Publication Date

24/03/2003

Volume

88

Pages

822 - 827

Keywords

Aged, Aged, 80 and over, Androgens, Angiogenesis Inhibitors, Disease Progression, Endothelial Growth Factors, Enzyme-Linked Immunosorbent Assay, Humans, Intercellular Signaling Peptides and Proteins, Lymphokines, Male, Middle Aged, Peripheral Nervous System Diseases, Prostate-Specific Antigen, Prostatic Neoplasms, Thalidomide, Treatment Outcome, Vascular Endothelial Growth Factor A, Vascular Endothelial Growth Factors