The efficacy of thalidomide at doses as low as 50 mg every other day was first reported at the VII International Multiple Myeloma Workshop in Stockholm, Sweden, in September 1999. This article discusses the duration of responses with low-dose thalidomide and the subsequent efficacy with thalidomide combination approaches. The median effective dose of thalidomide was 200 mg/d. Thalidomide's mechanism of action, particularly its effects on macrophages, is described. Current approaches to single-agent and combination therapy are presented.
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