01835nas a2200301   4500000000100000008004100001260001300042653001300055653002600068653002900094653002100123653002600144653001100170653002900181653002100210653002500231653002100256653002000277653001600297653001000313100001500323700001200338245005400350300001200404490000700416520109600423022001401519       2004                            d  c2004 Mar10aCachexia10aCarcinoma, Renal Cell10aClinical Trials as Topic10aErythema Nodosum10aGraft vs Host Disease10aHumans10aImmunosuppressive Agents10aKidney Neoplasms10aLeprosy, lepromatous10aMultiple Myeloma10aSarcoma, Kaposi10aThalidomide10aUlcer1 aJoglekar S1 aLevin M00aThe promise of thalidomide: evolving indications.  a197-2040 v403 a<p>Thalidomide was first used in the late 1950s but it was withdrawn from the market in the 1960s for its notorious teratogenic effects. This drug was more recently rediscovered as a powerful immunomodulatory and antiinflammatory agent and was approved by the FDA in 1998 for treatment of erythema nodosum leprosum. Thalidomide has shown great promise in advanced or refractory multiple myeloma either alone or in combination with other agents. It has also demonstrated benefits in a wide variety of disparate conditions such as aphthous and genital ulcers, cancer cachexia, HIV, tuberculosis and chronic graft versus host disease. Thalidomide is being investigated for treatment of renal cell carcinoma, and liver and thyroid cancers. Better understanding of its many mechanisms of action has provoked great interest in its potential use for treatment of various disorders. This review focuses on thalidomide's mechanisms of action, biochemistry, pharmacokinetics and its use in erythema nodosum leprosum as well as multiple myeloma, graft versus host disease, and renal cell carcinoma.</p>  a1699-3993