Thalidomide neuropathy in patients treated for metastatic prostate cancer

F. M. Molloy, M. K. Floeter*, N. A. Syed, F. Sandbrink, E. Culcea, S. M. Steinberg, W. Dahut, J. Pluda, E. A. Kruger, E. Reed, W. D. Figg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

84 Scopus citations


We prospectively evaluated thalidomide-induced neuropathy using electrodiagnostic studies. Sixty-seven men with metastatic androgen-independent prostate cancer in an open-label trial of oral thalidomide underwent neurologic examinations and nerve conduction studies (NCS) prior to and at 3-month intervals during treatment, NCS included recording of sensory nerve action potentials (SNAPs) from median, radial, ulnar, and sural nerves. SNAP amplitudes for each nerve were expressed as the percentage of its baseline, and the mean of the four was termed the SNAP index. A 40% decline in the SNAP index was considered clinically significant. Thalidomide was discontinued in 55 patients for lack of therapeutic response. Of 67 patients initially enrolled, 24 remained on thalidomide for 3 months, 8 remained at 6 months, and 3 remained at 9 months, Six patients developed neuropathy. Clinical symptoms and a decline in the SNAP index occurred concurrently. Older age and cumulative dose were possible contributing factors. Neuropathy may thus be a common complication of thalidomide in older patients, The SNAP index can be used to monitor peripheral neuropathy, but not for early detection.

Original languageEnglish
Pages (from-to)1050-1057
Number of pages8
JournalMuscle and Nerve
Issue number8
StatePublished - 2001
Externally publishedYes


  • Electromyography
  • Nerve conduction studies
  • Neuropathy
  • Thalidomide
  • Toxicity


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