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Why thalidomide may be making a comeback

May 22, 2000
Web posted at: 1:03 PM EDT (1703 GMT)

By Jessica Reaves

If there was ever a drug in need of a public relations overhaul, it's thalidomide. And now, thanks to recommendations aired this weekend at a meeting of the American Society of Clinical Oncologists, the long-reviled pharmaceutical could be headed back into the medical spotlight. Researchers testing thalidomide's efficacy as a cancer-fighting agent have reaffirmed the drug's potency, urging its continued use in conjunction with chemotherapy to combat a wide range of cancers. While it's not clear exactly how thalidomide works against cancer, scientists theorize the drug may boost immune system functioning or attack cancerous cells directly.

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Sunday's announcement marks another step in the continuing civic rehabilitation of thalidomide, which was banned decades ago after its widespread use as an anti-morning sickness medication was linked to horrible birth defects. In spite of lingering public distaste for the drug, the FDA in 1998 approved it as a treatment for leprosy, and the ASCO findings could plant the seeds for future approvals. While its effectiveness as a weapon against various illnesses is no longer in question, the rigors of a clinical trial will pale in comparison to the public's vivisection of thalidomide's risks.

"People harbor deep-seated fears about thalidomide," says TIME medical contributor Dr. Ian Smith. "Given its history, many patients have understandable concerns over short- and long-term side effects of the drug." Doctors who use thalidomide to combat cancer, AIDS or leprosy can help alleviate some of this anxiety by following a strict protocol, says Dr. Smith. "Only patients who are not pregnant and who do not plan to become pregnant should be prescribed thalidomide," he says. Physicians also tend to reserve the drug for patients who do not respond to other treatments -- a measure of caution that bears eloquent testimony to the shadow of fear thalidomide may never be able to shake.

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