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Thalidomide Not Linked to Better Lung Cancer Survival

Thrombotic events more likely in small cell lung cancer patients taking thalidomide than placebo

MONDAY, July 27 (HealthDay News) -- Treatment with thalidomide in combination with chemotherapy in patients with small cell lung cancer was not associated with improved survival, but was associated with a higher risk of thrombotic events, according to research published online July 16 in the Journal of the National Cancer Institute.

Siow Ming Lee, M.D., of the University College Hospital in London, and colleagues analyzed data from 724 patients with small cell lung cancer who received up to six cycles of etoposide and carboplatin, and were randomly assigned to also receive either placebo or thalidomide daily for up to two years.

In patients with limited-stage disease, the researchers found that survival was similar in both treatment groups, but in patients with extensive disease, those in the thalidomide group had worse survival (hazard ratio for death, 1.36). Compared to placebo, thalidomide was linked to a higher risk of thrombotic event, typically pulmonary embolus or deep vein thrombosis (hazard ratio, 2.13).

"Thalidomide might not be an effective anti-angiogenic drug as initially assumed. Although thalidomide was shown to suppress angiogenesis 15 years ago, the responsible mechanism has remained largely elusive," write the authors of an accompanying editorial, who also point out that "small cell lung cancer might be the wrong disease to test thalidomide and possibly other anti-angiogenic drugs. Clearly, not every tumor is equally angiogenic or equally dependent on angiogenesis."

Pharmion Ltd. provided thalidomide and placebo capsules for the study, and an editorial co-author reported financial relationships with Diagnoplex and Novartis.

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