REPOSITIONING INTELLIGENCE — EVIDENCE REPORT
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Generated: Nov 12, 2026, 11:43 PM UTC

DISCLAIMER: This report is for research and informational use only.
It is NOT medical advice, diagnosis, or treatment guidance.

DRUG–DISEASE PAIRING
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Drug:     Thalidomide
Disease:  Multiple Myeloma
Target:   Cereblon

EVIDENCE GRADE: Approved
Confidence Score: 96%
Evidence Level: Level 1 (RCT + regulatory approval)
Trial Phase: Phase III

MECHANISM
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Cereblon-dependent degradation of IKZF1/3 disrupts myeloma cell survival signaling.

OUTCOMES
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Improved response rates and survival in combination regimens; REMS mandated.

AI SUMMARY (generated March 15, 2026)
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Thalidomide plus dexamethasone demonstrated significant activity in relapsed myeloma, leading to FDA approval. REMS requirements reflect teratogenicity risk. Strong approved repurposing case.

KNOWN RISKS
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• Severe birth defects (absolute contraindication in pregnancy)
• Peripheral neuropathy
• Thromboembolism
• Sedation and constipation

CITATIONS
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[PUBMED] 11752346: Thalidomide for refractory myeloma
  https://pubmed.ncbi.nlm.nih.gov/11752346/

[PUBMED] 19717844: Lenalidomide and dexamethasone vs dexamethasone alone
  https://pubmed.ncbi.nlm.nih.gov/19717844/

[CLINICALTRIALS] NCT00029429: Thalidomide in multiple myeloma
  https://clinicaltrials.gov/study/NCT00029429

[FDA] 021430: Thalomid FDA approval
  https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=021430

PUBMED IDs: 11752346, 19717844
CLINICAL TRIAL IDs: NCT00029429

LAST VERIFIED: June 20, 2026
LAST UPDATED:  June 20, 2026
REVIEW STAGE:  published

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Repositioning Intelligence Platform · Research Mode