Thalidomide Produces Responses in Advanced Renal Cell Cancer
According to a recent article published in the British Journal of Cancer, thalidomide produces anti-cancer responses in patients with advanced renal cell cancer who have stopped responding to standard treatment.
The kidneys are a pair of bean shaped organs located on each side of the spine. The kidneys filter the blood and eliminate waste in the urine through a complex system of filtration tubules. All of the blood in the body passes through the kidneys approximately 20 times an hour. Renal cell cancer is an uncommon form of cancer that is most often characterized by the presence of cancer cells in the lining of the filtration tubules of the kidney. Advanced renal cell cancer refers to cancer that has spread outside the kidneys to different locations in the body. The prognosis for patients with advanced renal cell cancer following standard therapy is poor and novel treatment strategies are being evaluated to establish optimal care.
Thalidomide is a substance known for its antiangiogenesis properties and has demonstrated activity in various cancers. Angiogenesis is the formation of new blood vessels in the body and is a crucial component for the development of cancer. Blood vessels are needed to supply cancer cells with essential nutrients from the blood. Anti-angiogenesis is the inhibition of the formation of new blood vessels. By stopping blood vessels from forming, cancer cells are “starved” of nutrients, ultimately inhibiting cancer development and growth. In addition, more evidence is emerging that thalidomide is involved in a variety of processes which inhibit the progression of cancer. Some of these known inhibitory properties include the suppression of several cytokines (proteins secreted by immune cells), growth and angiogeneic factors including tumor necrosis factor alpha, basic fibroblast growth factor, vascular endothelial growth factor and interleukins.
Recently, researchers conducted a clinical trial evaluating high doses of thalidomide in 22 patients with advanced renal cell cancer who were either ineligible for or had stopped responding to conventional therapies. Following treatment with thalidomide, 15 patients achieved a stabilization of their disease and 2 patients achieved a partial disappearance of cancer. Of those patients whose disease stabilized following treatment, 7 had disease stabilization for over 6 months and 5 had disease stabilization for 3 to 6 months. Side effects included fatigue, constipation and neuropathy (loss of sensation in extremities).
These results indicate the effectiveness of thalidomide in patients with advanced renal cell cancer whose treatment options are limited. These positive findings have prompted researchers to initiate clinical trials for further evaluation of thalidomide in patients with renal cell cancer. Patients with advanced renal cell cancer may wish to speak with their physician about the risks and benefits of participating in a clinical trial evaluating thalidomide. (British Journal of Cancer, Vol 85, No 7, pp 953-958, 2001)
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