Thalidomide may help halt wasting in cancer patients

The question: Severe weight loss occurs in about half of all cancer patients, with death often resulting from malnutrition. Might thalidomide, a drug that targets the molecules thought to trigger this wasting, stem the weight loss?

This study randomly assigned 50 adults with inoperable pancreatic cancer to take 200 milligrams of thalidomide or a placebo daily. Participants already had lost at least 10 percent of their weight. After four weeks, those taking thalidomide had gained about one pound, compared with a loss of about five pounds for the placebo group. At eight weeks, people taking thalidomide weighed about the same as at the start of the study, whereas those on the placebo had lost about eight pounds. Measurements of arm muscle mass were greater for those taking thalidomide; grip strength did not vary between the groups. Average survival was about the same in both groups.

Who may be affected by these findings? Anyone with advanced pancreatic cancer. The disease has a five-year survival rate of 15 percent.

Caveats: Whether the findings would apply to people with other types of cancer requires further study. Also, a larger study would be needed to determine whether survival outcomes improve with the drug. The authors said thalidomide was well-tolerated. Side effects included drowsiness, numbness and rash; two people who took the drug and one who took the placebo developed blood clots in their legs. Thalidomide was given in the 1960s to combat morning sickness in pregnant women, but that use was stopped after the drug was shown to cause severe birth defects.

Bottom line: People with pancreatic cancer may want to ask an oncologist about thalidomide.

Find this study in the April issue of Gut; abstract available online at www.gutjnl.com.

Learn more about pancreatic cancer at www.cancer.gov and www.pancreasfoundation.org.