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Thalidomide + gefitinib is an investigational combination therapy consisting of two small molecule drugs: thalidomide, an immunomodulatory and anti-angiogenic agent, and gefitinib, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor. This combination has been studied for its synergistic antiproliferative and proapoptotic effects in non-small cell lung cancer (NSCLC), including both EGFR-TKI-sensitive and -resistant cases. Thalidomide acts by inhibiting angiogenesis, modulating immune responses, and interfering with tumor-promoting cytokines. Gefitinib inhibits the EGFR tyrosine kinase by binding to its ATP-binding site, thereby blocking downstream signaling pathways involved in cell proliferation and survival. The combined regimen enhances inhibition of EGFR phosphorylation as well as downstream AKT/MEK/ERK/p38 signaling pathways more effectively than either agent alone[1][2]. Clinical trials are ongoing to evaluate efficacy versus monotherapy in NSCLC patients with EGFR mutations[2].
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