Department of Pharmacology, Kodagu Institute of Medical Sciences, Madikeri, Karnataka

Department of Pharmacology, JJM Medical College, Davangere, Karnataka, India
Thalidomide ,chemotherapy ,CINV ,

Aim of the study is to analyze the benefits of thalidomide for prevention of nausea and vomiting induced by cancer chemotherapeutic agents. Electronic database search in PUBMED, Cochrane library, Google scholar was conducted using search terms “thalidomide” AND “vomiting”. Randomized or cross-over studies comparing antiemetic effects of thalidomide vs other active treatment or placebo in cancer patients >18yrs on treatment with emetogenic cancer chemotherapeutic agents were included for analysis. Complete control of vomiting was the primary outcome measure while the incidences of adverse drug reactions and complete control of nausea, anorexia were the secondary outcome measures analyzed. Inverse variance method and both random and fixed effect models were used in the analysis by RevMan 5.3 software. Total six eligible studies were included in the analysis. Complete control of delayed vomiting was 1.22 times (RR: 1.2, 95% CI: 1.11, 1.30, N=881), delayed nausea was 1.4 times (RR: 1.39, 95% CI: 1.19, 1.61, N=881) and anorexia was 1.65 times (RR: 1.65, 95% CI: 1.26, 2.16, N=183)higher in thalidomide group than in control group. Incidences of constipation (RR: 1.43, 95% CI: 1.21, 1.68, N=1031), rashes/pruriris (RR: 9.03, 95% CI: 1.72, 47.45, N=130), peripheral neuropathy (RR: 1.67, 95% CI: 1.06, 2.64, N=328) and sedation/somnolence (RR: 3.11, 95% CI : 1.90, 5.09, N=78) were higher in thalidomide group. Though significant, benefit of thalidomide for delayed vomiting appears to be minimal and for delayed nausea, doubtful. The benefits resemble the benefits ofNK1 receptor antagonists but its added benefits of anti-cancer actions may favor its use in cancer patients.

10 , 1 , 2020