Early reports of the efficacy of thalidomide as initial therapy for myeloma have been confirmed in recently reported data from Texas. As sole therapy, thalidomide brought about partial remission in 1/3 of previously untreated patients. A combined thalidomide/dexamethasone regimen resulted in a 70% response rate and many of these responses remained as long-lasting remissions. These are excitng results that compete with much stronger (and more toxic) other first line therapies for this disease. In patients who have been previously treated with more conventional chemotherapy, the response rate of a thalidomide/dexamethasone regime approaches 40-50%, again an exciting result given the relapse situation.