Gemcitabine [Gemzar®] is a nucloside analogue with clinical significant activity against different solid tumors. Currently, clinical research concentrates mainly on pancreatic, bladder, breast, ovary and non-small-cell lung cancer (NSCLC). In pancreatic cancer, it has been shown that the drug has meaningful impact on survival and disease-related symptoms which is superior to 5-Fluorouracil. In locally advanced and metastatic NSCLC, several phase II studies involving more than 400 patients showed validated response rates with gemcitabine in more than 20% of the patients. This has been confirmed in a randomized study showing equal activity of gemcitabine monotherapy compared to combination therapy with cisplatin/ etoposide. Combination therapy with cisplatin in NSCLC yields response rates in the range of 30 to 54%. Early phase II studies in patients with metastatic breast cancer have shown promising results with response rates between 46 and 25% in chemonaive and pretreated patients. In urogenital tumors, gemcitabine has activity in first- and second-line treatment, even in cisplatin-refractory tumors, with response rates of 20-30% in bladder cancer and 19-24% in ovarian cancer. Compared to other cytostatic drugs, gemcitabine is well tolerated in the majority of patients with mild myelosuppression and flu-like symptoms as the most reported side effects. Current research and further development concentrates on dose and schedule modifications of gemcitabine and on combination with other drugs or radiation which should lead to increased response rates and survival of patients with solid tumors.

Keywords:
Gemcitabine, Pancreatic cancer, Non-small-cell lung cancer
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© 1997 S. Karger AG, Basel
1997
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