It has been more than three decades since the withdrawal of thalidomide from the 
marketplace. Thalidomide is attracting growing interest because of its reported 
immunomodulatory and anti-inflammatory properties. Current evidence indicates 
that thalidomide reduces the activity of the inflammatory cytokine tumor 
necrosis factor-alpha by accelerating the degradation of its messenger RNA. 
Thalidomide inhibits angiogenesis. Recently, thalidomide was approved for sale 
in the United States for the treatment of erythema nodosum leprosum, an 
inflammatory complication of Hansen's disease. Thalidomide has been used 
successfully in several other dermatologic disorders, including aphthous 
stomatitis, Behcet's syndrome, chronic cutaneous systemic lupus erythematosus, 
and graft-versus-host disease, the apparent shared characteristic of which is 
immune dysregulation. Many recent studies have evaluated thalidomide in patients 
with HIV infection, in which this drug is an efficacious agent against oral 
aphthous ulcers, HIV-associated wasting syndrome, HIV-related diarrhea, and 
Kaposi's sarcoma. Only in the last several years has thalidomide been 
aggressively investigated for its antiangiogenic potential and immunomodulatory 
properties in various tumor types. Current research on thalidomide in oncology 
covers investigation in a wide range of both solid tumors and hematologic 
malignancies.