Thalidomide brings with its recollection of malformed new-borns in the 50s and 60s, and is justifiably viewed with extreme caution today.
Professor Angus Dalgleish, Professor of Oncology at St George’s University of London and Principal of the Institute for Cancer Vaccines and Immunotherapy, has studied the effects of THAL on cancer patients and has seen extremely positive results.
“Over 30 years ago, I was asked to look after a patient who had a very severe and serious autoimmune disease, i.e. when the body attacks its own self, and this patient was completely resistant to steroids.
“Reading suggested that thalidomide might be useful for this patient. She responded unbelievably well. It was quite a miracle considering how ill she was.
“This led us to wanting to look at this drug more carefully to see exactly what it did. In a very short time we realised this could be very useful for chronic infections, such as HIV, which was a big problem at the time and also the weight-loss that you get with cancer patients.
“Well it was found that patients who have multiple myeloma responded very well to this drug in a small study done in the United States. We thought we should then take this drug and look at all the effects in the immune system, in doing so we realized that when we did put it into the clinic there were problems with side effects.
“The ones with birth defects was well known but we could not get the drug long term because of really bad problems with neuropathy and damage to nerves. Therefore, we suggested to people and colleagues working at cellgene that it could be really useful if they made sisters and brothers of this basic thalidomide drug, and test them to see whether any of them could actually be useful without having the side effects. Within the 3rd generation of these drugs we found an ideal candidate which was far better than thalidomide and had none of the side effects.
“I was truly honoured to be able to give this to the first person in the world and conduct the phase one studies. These were so good, and the side effect problem so low, that we immediately put these into patients with multiple myeloma and lymphoma and now it is an incredible blockbuster. It has been used worldwide for these diseases and now we’ve been working on sons and daughters of these drugs to get a new generation of agents that can attack other parts of the immune system and pathways, to boost the effects to other drugs.
“In our work, we were amazed to find that this drug boosts our vaccines, so we have now even conducted clinical studies proving that when you give it with a vaccine the patient will make a much stronger immune response, even with ordinary vaccines such as the ones you use in pneumonia in elderly people. Many patients will not respond to that but if they’re given this drug first, they make excellent responses.”