Neue Indikationen für Thalidomid?

Anfang der 60er Jahre wurde das als Sedativum und Hypnotikum eingesetzte Thalidomid mit dem Handelsnamen Contergan® vom Markt zurückgezogen, da es unter der Einnahme zu Missbildungen bei 6000 - 10 000 Neugeborenen gekommen war. Trotzdem wurden nachfolgend individuelle Behandlungsversuche mit Thalidomid bei Erkrankungen wie Lepra oder Morbus Behçet unternommen. Unter der Einnahme wurde immer wieder eine deutliche Symptomverbesserung beschrieben. Jüngere Veröffentlichungen zeigen, dass Thalidomid antineoplastische, antiangiogenetische und immunmodulatorische Wirkungen hat. Insbesondere therapierefraktäre multiple Myelome können erfolgreich behandelt werden. Derzeit wird die Wirkung von Thalidomid in zahlreichen prospektiven Studien bei verschiedenen Malignomen evaluiert. Der folgende Artikel soll diese Entwicklung darstellen, die Anwendungsmöglichkeiten nennen, aber auch auf die Grenzen und Gefahren dieser Behandlung hinweisen.

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